TTC及FTC方案新辅助化疗治疗乳腺癌的疗效分析

Study on the efficacy of neoadjuvant chemotherapy with TTC and FTC regimens for the treatment of breast cancer

目的比较新辅助化疗方案TTC及FTC治疗乳腺癌的疗效。方法收集325例乳腺癌新辅助化疗患者的资料，其中TTC方案138例、FTC方案187例，并采用免疫组织化学法检测所有患者化疗前活组织检查标本TopoⅡa的表达状况。结果TTC组、FTC组乳腺癌总缓解率（RR）分别为87．7％、67．4％，两组差异有统计学意义（P=0．000）；而分层分析显示：在TopoⅡa（-）组，TTC、FTC两组患者RR差异均有统计学意义，而TopoⅡa（＋）Her-2（-）组，FTC组为79．4％，TTC组为87．8％，差异无统计学意义（P=0．266）；TTC组、FTC组患者的病理完全缓解率分别为13．7％、11．2％，差异无统计学意义（P=0．491）。结论新辅助化疗TTC较FTC方案有较高的缓解率；而对于TopoⅡa（-）患者，应用或联合紫杉类药物治疗可能取得更好的疗效。

Objective To investigate the efficacy of TTC and FTC regimens as neoadjuvant chemotherapy in breast cancer. Methods Collecting clinical data of 325 patients received neoadjuvant chemotherapy with TTC and FTC regimens from June 2004 to April 2008, among them 138 patients received neoadjuvant chemotherapy with TIC regimen in one group, and 187 patients received neoadjuvant chemotherapy with CTF regimen in the other group. The expression of Topo Ⅱ a in specimen of 325 patients before neoadjuvant chemotherapy were detected by immunohistochemical method. Results Among the 325 cases of neoadjuvant chemotherapy, the overall response rate （RR） was 87.7 % in TIC arm and 67.4 % in FTC arm （P = 0.000） , but in the group of Topo Ⅱ a（＋） Her-2（-）, the overall response rate （RR） was 87.8 % in TTC arm and 79.4 % in FTC arm （P =0.266）, and in the groups of Topo Ⅱ a（-）, there was statistical significance; the pathologic complete response rate （pCR） was 13.7 % in TTC arm and 11.2 % in CTF arm （P =0.491）. Conclusion TTC regimen is superior to FTC regimen in the response rate of neoadjuvant chemotherapy, but patients with negative expression of Topo Ⅱ a may get more benefits from neoadjuvant taxane and anthracycline chemotherapy.