紫杉醇联合表阿霉素在局部晚期乳腺癌新辅助化疗中的近期疗效观察

Observation on the therapeutic effect of neoadjuvant chemotherapy with paclitaxel and epirubicin for locally advanced breast cancer

目的本研究的目的是观察新辅助化疗方案表阿霉素联合紫杉醇的近期临床疗效和毒性反应情况。方法将31例局部进展期乳腺癌患者术前给予表阿霉素联合紫杉醇4周期化疗,表阿霉素60 mg/㎡d1,紫杉醇175mg/㎡d1每3周为1个周期,出现严重的毒副反应或疾病进展才准予停药。结果所有患者术前共行119个周期的化疗;31例患者中29例患者接受了4个周期的化疗。术后出现完全缓解(CR)4例和部分缓解(PR)21例;病情稳定(SD)4例和疾病进展(PD)2例。最常见的Ⅰ/Ⅱ级毒性反应为脱发,最常见的Ⅲ/Ⅳ级毒性反应为中性粒细胞减少症。无1例因毒性反应引起死亡。结论该研究表明:新辅助化疗表阿霉素联合紫杉醇方案的病理反应疗效令人鼓舞,并提示表柔比星在心脏毒性方面可能是替代阿霉素的最佳选择。

Objective：Neoadjuvant chemotherapy（NC）is yet to be established as the definitive treatment regimen for locally advanced breast cancer（LABC）. The aim of this study was to determine the efficacy and toxicity of NC with epiru-bicin and paclitaxel. Methods：31 patients with LABC were enrolled in study. All patients were scheduled to receive four cy-cles of 60 mg/ m2 epirubicin and 175 mg/ m2 paclitaxel every 3 weeks,preoperatively,unless they developed profound side effects or disease progression. Results：In all,119 cycles of chemotherapy were administered preoperatively;29 of the 31 patients underwent all four cycles of designated treatment. Complete disappearance of invasive foci of the primary tumor, and negative axillary lymph nodes were confirmed in four patients,post operation. Partial remission（PR）21 cases,Stable disease（SD）4 cases and Progression disease（PD）2 cases. The most common gradeⅠ/ Ⅱtoxicities were alopecia. Neutro-penia was the most common grade 3 / 4 toxicity. However,none of the toxicities resulted in cessation of the treatment. Con-clusion：The encouraging pathologic response observed in the patients treated with epirubicin plus paclitaxel NC in this study suggests that epirubicin could be a substitute for doxorubicin,which is the most cardiotoxic agent.