多西紫杉醇与紫杉醇联合吡柔比星和环磷酰胺在局部进展期乳腺癌化疗中的对比观察

Clinical comparative study of neoadjuvant chemotherapy outcome in locally advanced breast cancer： docetaxel versus paclitaxel plus pirarubicin hydrochloride and cyclophosphamide

目的比较多西紫杉醇与紫杉醇联合吡柔比星（THP）和环磷酰胺（CTX）的新辅助化疗方案治疗局部进展期乳腺癌的临床疗效和毒性。方法97例ⅡB期至ⅢC期女性乳腺癌患者随机分为两组：多西紫杉醇组49例给予多西紫杉醇＋THP＋CTX方案；紫杉醇组48例紫杉醇＋THP＋CTX方案。两组新辅助化疗均为21d一疗程，共完成4个疗程。结果多西紫杉醇组原发病灶完全缓解率和病理完全缓解率分别为28．6％和26．5％，均显著高于紫杉醇组（10．4％和8．3％）；化疗后区域淋巴结病理转阴性率多西紫杉醇显著高于紫杉醇组（40．6％和12．9％）。但多西紫杉醇组Ⅲ、Ⅳ度血液系统毒性反应、Ⅱ度以上肝功能损伤、水肿发生率分别为71．4％、53．1％和24．5％，均显著高于紫杉醇组（46．9％、27．1％和4．2％）。结论相对于紫杉醇，多西紫杉醇联合吡柔比星和环磷酰胺治疗局部进展期乳腺癌的疗效更显著。

Objective To compare the efficacy and toxicity of neoadjuvant chemotherapy of docetaxel with paclitaxel plus pirarubicin hydrochloride （THP） and cyclophosphamide （CTX） in locally advanced breast cancer （ LABC ）. Methods A total of 97 LABC cases were randomly divided into 2 groups： docetaxel group （n = 49, taxotere plus THP ＆ CTX） and paclitaxel group （n = 48, paclitaxel plus THP ＆ CTX）. Neoadjuvant chemotherapy had four cycles of 21 days each. Results The clinical and pathological complete remission rates of docetaxel group was 28.6% and 26. 5% respectively. They were significantly higher than those of paclitaxel group （10. 4% and 8.3% ）. Furthermore the pathological negative rate of regional lymph node in docetaxel group was also significantly higher than that of paclitaxel group （40. 6% vs. 12. 9% ）. However, grade I!1 - 1V blood system toxic reaction was found in 71.4% cases, grade ]I - 1V liver dysfunction in 53.1% cases and edema in 24. 5% cases among docetaxel group. They were higher than those among paclitaxel group （46. 9%, 27.1% ＆ 4. 2% ）. Conclusion Compared with paclitaxel, the combined regimen of docetaxel plus THP and CTX offers better outcomes for locally advanced breast cancer.