内乳动脉置管化疗对局部晚期乳腺癌患者远期疗效的影响

Long term therapeutic effect of preoperative chemotherapy through internal mammary artery on patients with local advanced breast cancer

目的比较术前经内乳动脉化疗和全身静脉化疗对局部晚期乳腺癌远期疗效的影响。方法随机将85例临床分期基本相同的晚期乳腺癌分为治疗组和对照组。治疗组41例行内乳动脉插管化疗,对照组44例行全身化疗,手术后再经放射治疗和全身化疗。经5年随访,对局部复发,骨、肝、胸肺转移,以及两组1、3、5年生存率进行统计分析。结果治疗组局部复发、骨转移、肝转移、胸肺转移分别为11、6、7、2例,1、3和5年存活率分别为100%、90.2%和80.5%;对照组局部复发、骨转移、肝转移、胸肺转移分别为11、5、10、10例,1、3和5年存活率分别为95.5%、77.3%和59.1%。结论内乳动脉置管化疗与全身化疗相比较,可减少晚期乳腺癌胸肺转移率并提高其5年生存率。

Objective To compare long term therapeutic effect of preoperative chemotherapy through internal mammary artery versus system chemotherapy on patients suffering from local advanced breast cancer. Methods Eighty-five cases of local advanced breast cancer with same stage were randomly divided into a therapy group （ n =41 ） and a control group （ n = 44）. The patients were given preoperative local chemotherapy through internal mammary artery in the therapy group and system chemotherapy via peripheral veins in the control group. After operation radiotherapy and intravenous chemotherapy were performed. All patients were followed up for 5 years. Local recurrence, bone metastasis, hepatic metastasis, thoracic metastasis and the survival of 1, 3 and 5 years in the two groups were statistically analyzed. Results The local recurrence, bone metastasis, hepatic metastasis, thoracic metastasis occurred in 11, 6, 7 and 2 cases respectively in the therapy group, and in 11, 5, 10 and 10 cases respectively in the control group. The survival rates of 1,3 and 5 years were 100%, 90. 2% and 80. 5% respectively in the therapy group, and 95.5%, 77. 3% and 59.1% respectively in the control group. Conclusions The preoperative chemotherapy via internal mammary artery can decrease thoracic metastasis and raise 5 year survival rate for local advanced breast cancer.