多西他赛联合表阿霉素新辅助治疗局部晚期乳腺癌的临床观察

The clinical study on neoadjuvant chemotherapy with combination of Docetaxel and Pharmorubicin for locally advanced breast cancer

目的评估多西他赛联合表阿霉素新辅助治疗乳腺癌的临床疗效和毒性反应。方法2005年6月至2007年3月，94例经空芯针活检组织学诊断证实的乳腺癌患者在术前接受新辅助化疗，方案为多西他赛75mg／m^2（第1天）和表阿霉素80mg／m^2（第1天）静脉注射，每3周为1个周期，共2～4个周期，化疗后12～16d行手术治疗。结果原发病灶临床有效率为80％（76／94），其中临床完全缓解为22％（21／94），临床部分缓解为58％（55／94），疾病稳定为17％（16／94），疾病进展为2％（2／94），病理完全缓解为3％（3／94）。常见的毒性反应有：中性粒细胞减少症，脱发和恶心呕吐。76例（80％）患者发生Ⅲ～Ⅳ度中性粒细胞减少症，4例发生3～4度血小板减少症，84例发生重度脱发。90例（95％）患者使用粒细胞集落刺激因子（G—CSF）支持治疗。无因新辅助化疗引起的败血症和死亡病例。结论多西他赛联合表阿霉素的方案在新辅助治疗乳腺癌中疗效显著，耐受性较好。

Objective To evaluate the clinical efficacy and toxicity of combination neoadjuvant chemotherapy with docetaxel and pharmorubicin in the treatment of locally advanced breast cancer. Methods From June 2005 to March 2007, 94 breast cancer patients who have been pathologically confirmed by core needle biopsy were treated with neoadjuvant chemotherapy before operation. Docetaxel 75 mg/m^2 plus pharmorubicin 80 mg/m^2 were administered as intravenous infusion on the first day of each 3-week cycle. Accepted 2 to 4 cycles of the treatment, the patients were underwent surgery after 12 to 16 days. Results The overall response rate （RR） was 80% （76/94）. The complete clinical response rate （CR） was 22% （21/94）. The partial response rate （PR） was 58% （55/94）. The stable disease （SD） rate was 17% （16/ 94）. The progress disease （PD） rate was 2% （2/94）. The pathological complete rate （pCR） was 3% （3/ 94）. The major toxic reactions of the therapy were neutropenia, alopecia, nausea and vomit. 76 patients （80%） suffered with grade 3 to 4 neutropenia. 4 patients suffered with grade 3 to 4 thrombocytopenia. 84 patients suffered with severe alopecia. 90 patients （95%） accepted supportive treatment of G-CSF. Septicemia and death were not occurred in this study. Conclusion The combination neoadjuvant chemotherapy with docetaxel and pharmorubicin is an effective method to treat breast cancer and the toxicities are tolerable.