多西他赛联合表柔比星新辅助化疗治疗炎性乳腺癌效果观察

Clinical Observation of Docetaxel Combined with Epirubicin on the Neoadjuvant Chemotherapy for Inflammatory Breast Cancer

目的：研究多西他赛（ DOC）联合表柔比星（ EPI）新辅助化疗方案治疗炎性乳腺癌（ inflammatory breast cancer，IBC）的临床疗效、毒性反应和预后。方法选择我院2008年7月-2013年10月收治的 IBC 53例，按化疗方案不同分为研究组22例和对照组31例，研究组应用 DOC 联合 EPI 治疗方案，对照组应用5-氟尿嘧啶（5-FU）联合EPI、环磷酰胺（ CTX）方案，21 d为1个周期，治疗4个周期后3~4周视情况行根治性切除术。术后评估两组临床疗效及毒性反应，随访1年，评价预后。结果研究组部分缓解率和总有效率均高于对照组（ P 〈0.05）。研究组1例、对照组2例因疾病进展未能接受手术治疗。随访1年，研究组远处转移率低于对照组，无瘤生存率高于对照组（P 〈0.05）。结论 DOC联合 EPI新辅助化疗方案治疗 IBC的临床疗效显著，毒副作用可耐受，可能是 IBC 新辅助化疗的优选方案。

Objective To observe the therapeutic efficacy,toxic reaction and prognosis of Docetaxel（DOC） combined with Epirubicin（ EPI）on the neoadjuvant chemotherapy for inflammatory breast cancer（ IBC）. Methods A total of 53 IBC patients during July 2008 and October 2013 were divided into research group（n=22）and control group （n=31）based on different chemotherapies. The research group was treated with DOC combined with EPI,while the control group received 5-Fluorouracil（5-FU）combined with EPI and Cyclophosphamide（CTX）,and one course was 21 d. Radical resection was performed 3-4weeks after a 4-course chemotherapy. Curative effect and toxic reaction were e-valuated after the operation in the two groups,and the prognosis was evaluated after one year of follow-up. Results Compared with those in control group,the values of partial remission and total effective rate were significantly higher in research group（P〈0. 05）. The radical resection was not performed because of developed pathogenetic condition for 1 patient in research group and 2 patients in control group. The one-year follow-up showed that the metastasis rate in re-search group was significantly lower than that in control group,while the disease free survival rate in research group was significantly higher than that in control group（P〈0. 05）. Conclusion Chemotherapy plan of Docetaxel combined with Epirubicin has better efficacy in the treatment of IBC,and the relevant toxic and side-effect are tolerable,thus it may be an preferred neoadjuvant chemotherapy plan for IBC.