两种新辅助化疗方案治疗进展期乳腺癌的疗效对比研究

Comparison on clinical efficacy of neoadjuvant chemotherapy in treatment of stage Ⅱ-III breast cancer

目的探讨表柔吡星联合多西他赛（ED方案）与环磷酰胺＋表柔吡星＋5-氟尿嘧啶（CEF方案）两种新辅助化疗方案对进展期乳腺癌的临床疗效。方法选取2010年5月至2013年2月间收治的90例Ⅱ～Ⅲ期择期手术乳腺癌患者为研究对象，随机分为A（n=47例）和B（n=43例）两组，A组患者采用ED方案治疗，B组患者采用CEF方案治疗，对比两组患者的临床疗效和不良反应。结果化疗结束后，A组患者KPS得分（84．7±6．4）高于B组（81．4±5．5），差异有统计学意义（P=0．010）。A组患者临床完全缓解率、总有效率分别为10．6％和87．2％，B组患者分别为7．0％和83．7％，差异均无统计学意义（P=0．471，P=0．436）。两组患者不良反应类型、发生率和不良反应级别构成比较，差异均无统计学意义（P〉0．05）。结论ED方案与CEF方案的临床疗效与不良反应发生率相近，患者经前者治疗后表现出更高的生活质量，值得临床推广。

Objective To conduct comparative study on clinical efficacy of neoadjuvant chemother- apy between EPI ＋ DXL （ED） scheme and CTX ＋ EPI ＋ 5-FU （CEF） scheme in treatment of stage I1 -III breast cancer. Methods 90 admitted patients with breast cancer from May. 2010 to Feb. 2013 were were randomly divided into group A （n = 47 cases ） and group B （n = 43 cases ）. Group A were given ED scheme, and group B CEF scheme. Clinical efficacy and adverse reactions were compared between two groups. Results 1. After chemotherapy, KPS score （ 84. 7 ± 6.4） of group A was higher than that of group B （81.4 ± 5. 5） ,the difference was statistically significant （P =0. 010）. 2. clinical complete remis- sion rate （10. 6% ） and total control rate （87.2%） of group A were not statistically different （P =0. 471 and P = 0. 436 respectively） when compared with group B （7.0% and 83.7% respectively）. 3. Drug toxici- ty type, level and toxicity of two groups were similar without significant differences （ P 〉 0.05 ）. Conclu- sions Clinical efficacy and adverse reactions of neoadjuvant chemotherapy of ED scheme and CEF scheme was similar, but the patients of ED scheme show higher quality of life, which is worthy of clinical promotion.