盐酸吡柔比星术前介入化疗治疗局部晚期乳腺癌的临床研究

Curative Effect of Preoperative Pirarubicin Intervention Chemotherapy on Local Advanced Breast Cancer

目的：探讨吡柔比星（Pirarubicin，THP）在原发性局部晚期乳腺癌介入治疗中的作用。方法：选取2001年5月至2006年4月收治68例原发性局部晚期乳腺癌患者，随机分为术前盐酸吡柔比星介入化疗（区域内灌注化疗）和术前全身静脉化疗。36例患者在放射科DSA室，采用经皮血管穿刺（Seldinger）法经右或左股动脉穿刺。将导管置入患侧锁骨下动脉造影证实导管位于惠侧胸廓内动脉内或患侧锁骨下动脉与胸廓内动脉开口处的近端后，立即缓慢注入THP60～80mg、5-Fu750mg、CTX800mg，化疗药物推注完毕后，拔除导管，局部加压包扎，1个疗程即结束.如局部病期较晚，无法施行手术，3～4周后可重复介入化疗，观察其临床疗效。32例患者用相同方案采用全身静脉化疗.结果：介入化疗组临床完全缓解（CR）5例，占13．9％，临床部分缓解（PR）27例，占75．0％，病情稳定（SD）4例，占11．1％，进展（PD）0例。总有效率为88．9％。全身静脉化疗组临床完全缓解（CR）1例，占3．1％，临床部分缓解（PR）18例，占56．3％，病情稳定（SD）13例，占40．6％，进展（PD）0例。总有效率为59．4％。二者比较有统计学差异（P〈0．05，X^2=7．87）：结论：THP用于局部晚期乳腺癌介入化疗，近期疗效满意，而且副作用少，适于进一步推广及应用。

Objective： To investigate the effect of preoperative pirarubicin intervention chemotherapy on local advanced breast cancer. Methods- During May 2001 and April 2006, a total of 68 patients with local advanced breast cancer were collected and randomly divided into 2 groups： 36 patients in the preoperative intervention chemotherapy group （Group A） and 32 patients in the preoperative venous chemotherapy （Group B）. For patients in Group A, Seldinger technique （through ar- teria femoralis and arteria ulnaris） was used, a catheter was placed on the proximal side of the junction of subclavicular ar- tery and the top of interathoracic artery via corlicaus and chemotherapeutic drugs were instilled （Pirarubicin 60-80mg, 5-Flu- orouracil 750mg, Cytoxan 800mg）. The 32 patients in Group B received preoperative chemotherapy intravenously （Pirarubicin 60-80mg, iv, dl, 5-Fluorouracil 750mg, iv, dl, Cytoxan 800mg, iv, dl）. Results： The complete response rate and partial response rate were 13.9% and 75.0% in Group A, and were 3.1% and 56.3% in Group B, with significant diference between the two groups （P〈0.05,x^2=7.87）. Conclusion： The arterial infusion chemotherapy through the arteria ulnaris has better effect on local advanced breast cancer.