术前动脉区域灌注化疗治疗Ⅲ期乳腺癌的临床研究

Clinical study of preoperative intra-arterial infusion chemotherapy for stage III breast cancer

目的探讨术前动脉区域灌注在Ⅲ期期乳腺癌治疗中的价值。方法分别对24例和23例Ⅲ期乳腺癌患者行术前动脉区域灌注和全身静脉化疗2～3个疗程。结果动脉区域灌和全身静脉化疗组病理性完全缓解率和总有效率为16.7%、4.3%和91.7%、78.3%(P<0.05);分期降低率分别为:62.5%和39.1%(P<0.05);两疗组5年总的生存率(OS)分别为83.3%和78.3%;5年无病生存率(DFS)分别为75%和56.5%,(P<0.05)。结论术前动脉区域灌注化疗能降低乳腺癌患者的分期,提高根治率,对延长无病生存期有积极的临床意义,但是远期疗效无明显改善。

Objective To study the clinical value of preoperative intra-arterial infusion chemotherapy for medium advanced breast cancer. Methods The intra-arterial infusion chemotherapy was carried out in 24 stage Ⅲ breast cancer patients for 2-3 cycles before operation, and compared with 23 concurrent patients with preoperative vein infusion chemotherapy. Results The PCR and overall response rate of the two groups were 16.7% ,4. 3%and 91.7% ,78. 3% （P 〈0. 05） separately. The stages debased rate were 62. 5%and 39. 1% separately. The 5 year survival rate of two groups was 83.3% and 78.3% respectively（ P 〉 0. 05 ）. The disease free survival rate of the two groups was 75 % and 56. 5 % respectively, P 〈 0. 05 ）. Conclusion Preoperative intra-arterial infusion chemotherapy can down grade the stage of patients with advanced breast cancer,improve the rate of radical masteetomy, obviously prolong the disease free survival time of the patients, and reduce or delay recurrence or metastasis, however, it cannot improve the long curative effect.