T_2期乳腺癌新辅助化疗后行保乳手术的临床观察

Breast Conservation Therapy after Neoadjuvant Chemotherapy for Patients with T_2 Stage Breast Cancer

目的探讨T2期乳腺癌新辅助化疗后保乳手术治疗的可行性及疗效。方法对有保乳愿望的T2期乳腺癌患者术前行新辅助化疗,2个周期后评价疗效,达到保乳手术指征的行保乳术,共36例,并随机抽取同期36例T2期乳腺癌根治术患者进行疗效对比。结果保乳组36例患者,术前均经过2个疗程的新辅助化疗,并达到保乳指征后行保乳手术治疗,术后常规放疗、化疗。对照组36例均行根治术,随访3～5年,两组无复发生存率分别为88%、86%,两者比较无统计学意义,P<0.05。结论T2期乳腺癌新辅助化疗后可提高保乳率,改善患者生活质量,随访3～5年,与同期根治术相比,治疗效果相同,值得临床推广应用。

Objective To evaluate the possibility and the outcome of breast conservation therapy for patients with T2 stage breast cancer after neoadjuvant chemotherapy. Methods The patients with T2 stage breast cancer were treated with two courses of neoadjuvant chemotherapy. Then,36 patients eligible for breast-conserving therapy were treated by breast-conserving surgery. The control group was 36 patients who were treated by mastectomy and axillary dissection at the same time. After completion of local therapy, all patients received adjuvant chemotherapy and radiotherapy. Results Follow-up for 3 - 5 years, the relapse-free survival rates in conservative and non-conservative local treatment groups were 88% and 86% respectively. The differ-ence was not significance （ P 〈 0.05 ）. Conclusion The neoadjuvant chemotherapy increase the rate of breast conservation therapy in patients with T2 stage breast cancer and the breast conservation therapy have not on significant impact on relapse-free survival in these patients. Therefore, this treatment modality is possible.