不同新辅助化疗方案治疗乳腺癌的疗效观察

Evaluation of Two Different Regimens as Neoadjuvant Chemotherapy for Breast Cancer

目的比较两种不同化疗方案治疗乳腺癌的疗效和毒副反应。方法用CAF和TAC化疗方案治疗60例Ⅱb～Ⅲc期乳腺癌3,周为1个疗程,所有患者完成3个疗程。新辅助化疗CAF组:5-氟尿嘧啶500 mg/m2第1、8天持续4 h静脉注射,吡柔比星50 mg/m2第1天静脉注射及环磷酰胺500 mg/m2第1、8天静脉注射;TAC组:多西他赛75 mg/m2第1天持续3 h静脉注射,吡柔吡星50 mg/m2第1天静脉注射,环磷酰胺500 mg/m2第1、8天静脉注射。结果 CAF方案总有效率56.7%,其中完全缓解(CR)1例,临床部分缓解(PR)16例,无变化者(NC)13例;TAC方案总有效率83.3%,其中完全缓解(CR)4例,临床部分缓解(PR)21例,无变化者(NC)5例。两者总有效率差异有统计学意义(P<0.05),两种方案治疗的毒副反应,除脱发、白细胞毒性,差异有统计学意义,其他差异均无统计学意义。结论 TAC方案在乳腺癌治疗中疗效显著且耐受良好,是优于CAF的化疗方案。

Objective To compare the efficacy and toxicity of two different regimens as neoadjuvant chemotherapy for breast cancer. Methods Sixty-four patients with stage Ⅱb-Ⅲc breast cancer received two cycles of TAC or CAF regimen neoadjuvant chemotherapy and we compared the efficacy toxicity of them.Patients in FEC arm received combination of 5-fluorouracil（5-Fu） 500 mg/m2 by 4-hour continuous infusion on D1 and D8,pirarubicim 500 mg/m2 by intravenous injection on D1,and cyclophosphamide（CTX） 500 mg/m2 by intravenous injection on D1 and D8.Patients assigned to the TAC arm received docetaxel,75mg/m2 by intravenous injection on D1,pirarubicim 50 mg/ m2 by intravenous injection on D1,and cyclophosphamide（CTX） 500 mg/m2 by intravenous injection on D1 and D8.All patients were treated by operation 2 weeks later and radiotherapy was added. Results The clinical objective responses of Group TAC were 4 cases of CR 21 cases of PR,5 cases of SD and 83.3%（25/30）of RR.Group CAF were 1 case of CR,16cases of PR,13 cases of SD and 56.7%（18/30）of RR.the difference of chemotherapeutic effect between the groups had a significance（P0.05）.There was a significant difference in neutropenia and trichomadesis.The other adverse sffects of Group TAC and Group CAF were no significantly different. Conclusion The combination of TAC is more effective than regimen of CAF and it is a well-tolerated regimen as neoadjuvant chemotherapy.