TA方案与TC方案在乳腺癌保乳术后辅助化疗中的比较

A comparative study on efficacy and adverse reactions of TA scheme and TC scheme in treatment of breast cancer after breast- conserving operation

目的探讨多西他赛联合吡柔比星（TA）方案与多西他赛联合环磷酰胺（TC）方案在乳腺癌保乳术术后辅助化疗中疗效和不良反应发生率的比较。方法回顾性分析2008年10月至2013年10月收治的60例乳腺癌患者资料,采取保乳治疗后分别进行辅助化疗,30例接受TA方案辅助化疗,30例接受TC方案辅助化疗。随访8～60个月,分别观察两组中患者3年无病生存率、同侧乳房内肿瘤复发率、远处转移发生率及骨髓抑制程度、口腔溃疡、胃肠道不良反应的发生率。结果 TA组和TC组3年无病生存率（DFS）分别为96.7%和90.0%,差异无统计学意义（P〈0.05）。两组同侧乳房内肿瘤复发率和远处转移发生率比较,差异无统计学意义（P〉0.05）。TC组患者白细胞数显著高于TA组患者白细胞数目,差异均有统计学意义（P〈0.05）。TC组胃肠道不良反应率明显低于TA组（6.7%vs.40.0%）,差异具有统计学差异（P〈0.05）。TC组口腔溃疡的发生率明显低于TA组（3.3%vs.26.7%）,差异具有统计学意义（P〈0.05）。结论乳腺癌患者实施保乳术后采用TC或者TA辅助化疗方案,术后生存率、局部复发和远处转移的风险无明显差异,但TC方案相比TA方案不良反应发生率明显下降,TC辅助化疗方案优于TA方案。

Objective To compare the efficacy and adverse reactions of TA scheme and TC scheme in treatment of patients with breast cancer after breast- conserving operation. Methods The data of sixty patients with pathologically confirmed breast cancer were retrospectively analyzed,among them 30 patients received TA scheme,while others received TC scheme. The free survival rate of disease,rate of cancer recurrence,rate of cancer metastasis,the degree of bone marrow depression,rate of occurrence of oral ulcers and the incidence of gastrointestinal side reactions were studied and compared. Results The 3- year disease- free survival（ DFS） rates in TA group and TC group were 96. 7% and 90.0% respectively,the difference was not statistically significant（ P 0. 05）; the difference in recurrence rate of bilateral breast tumor and the incidence of distant metastasis was not statistically significant（ P 0. 05）. White blood cell count in patients with TC group was significantly higher than that of patients with TA group,and the difference was statistically significant（ P 0. 05）. The gastrointestinal adverse reactions in TC group were significantly lower than those of TA group（ 6. 7% vs. 40. 0%）,the difference was statistically significant（ P 0. 05）; and the incidence of oral ulcers in TC group was significantly lower than that of TA group（ 3. 3% vs. 26. 7%）,and the difference was statistically significant（ P 0. 05）. Conclusion There was no difference between these two groups in disease free survival rate,cancer recurrence rate and cancer metastasis. But the TC scheme has a certain superiority in less occurrence of adverse reactions.