老年局部晚期乳腺癌新辅助化疗的疗效分析

The Efficacy Analysis of Neoadjuvant Chemotherapy in the Elderly Patients with Locally Advanced Breast Cancer

目的老年乳腺癌患者具有伴随疾病多，化疗耐受性相对较差等特点，本研究旨在分析新辅助化疗在老年局部晚期乳腺癌中的疗效。方法收集2004年1月至2011年12月经细胞学或组织学证实的老年局部晚期乳腺癌29例。全部患者接受术前2～6个周期的新辅助化疗。化疗方案分别为：CMF（环磷酰胺，甲氨蝶呤，氟尿嘧啶），CEF（环磷酰胺，表柔比星，氟尿嘧啶），TE（多西他赛，表柔比星）。化疗后按照实体瘤疗效评价标准（RECIST 1.1）评价近期疗效。不良反应按照WHO抗肿瘤药物毒性反应分级标准分为0～Ⅳ级。采用电话和信件的方式进行随访。结果29例患者中，CR 2例（6.9%），PR 19例（65.5%），SD 6例（20.7%），PD 2例（6.9%），总有效率（CR＋PR）为72.4%（21/29）。本组中无严重心脏毒性反应，无副反应导致的死亡事件发生。术后随访12至84个月，随访率为93.1%。3年总生存率为51.3%。结论新辅助化疗在某些老年局部晚期乳腺癌患者中可能是安全而有效的。

Objective There are more comorbidity in elderly patients with breast cancer who are poorly tolerable to chemotherapy. The goal of this study is to analyze the clinical efifcacy of neoadjuvant chemotherapy in the elderly patients with locally advanced breast cancer （LABC）. Methods From January 2004 to December 2011, 29 patients with LABC diagnosed by cytological or histological pathology were treated with neoadjuvant chemotherapy operatively. The patients were treated for 2-6 cycles of different regimens, including CMF（CTX, MTX, 5-Fu）;CEF（CTX, EPI, 5-Fu）;TE（Doc, EPI）. Chemotherapy response was evaluated by RECIST 1.1 and the toxicity was estimated by WHO evaluation standard. The way of follow-up was telephone or letter. Results 29 patients, there was CR in 2 cases （6.9%）, PR in 19 cases （65.5%）, SD in 6 cases （20.7%）, PD in 2 cases （6.9%）;and the overall response rate （CR＋PR） was 72.4% There were no severe cardiotoxicity and chemotherapy related death. The duration of follow-up was from 12 months to 84 months, and the rate of follow-up was 93.1%. The overall survival rate of three years was 51.3%. Conclusion Neoadjuvant chemotherapy in some elderly patients with LABC may be safe and effective.