表柔比星、环磷酰胺联合多西他赛新辅助化疗方案对三阴性乳腺癌的疗效观察

Curative Effect of Epirubicin, Cyclophosphamide Combined with Docetaxel Neoadjuvant Chemotherapy on Triple Negtive Breast Cancer

目的 探讨表柔比星、环磷酰胺联合多西他赛新辅助化疗（NACT）治疗三阴性乳腺癌（TNBC）的临床疗效。方法将106例乳腺癌患者分为TNBC组31例和非TNBC组75例。两组均给予表柔比星、环磷酰胺联合多西他赛新辅助化疗,化疗后16~21 d进行手术治疗。比较两组近期疗效、毒副反应发生率以及3年和5年生存率。结果 新辅助化疗后TNBC组的完全缓解率（CR）和病理完全缓解率（pCR）均显著高于非TNBC组,差异具有统计学意义（P〈0.05）,但两组总有效率比较差异无统计学意义（P〉0.05）。两组主要毒副反应为恶心呕吐、白细胞减少、骨髓抑制、胃肠道反应、脱发、心脏毒性等,组间比较差异无统计学意义（P〉0.05）。TNBC组3年生存率低于非TNBC组（74.2%vs 86.7%）,TNBC组达到pCR的患者其5年生存率显著高于未达到pCR患者（85.7%vs 41.2%,P〈0.05）。结论 表柔比星、环磷酰胺联合多西他赛新辅助化疗方案可提高TNBC患者CR率和pCR率,毒副反应可耐受,可作为TNBC患者优选的新辅助化疗方案。

Objective To investigate the clinical effect of epirubicin, cyclophosphamide combined with docetaxel neoadjuvant chemotherapy （NACT） in treatment of triple negtive breast cancer （TNBC）. Methods 106 patients with breast cancer were divided into TNBC group （31 cases） and non-TNBC group （75 cases）. All patients were treated with epirubiein, cyelophosphamide combined with docetaxel neoadjuvant chemotherapy, and given surgical treatment after 16 - 21 d of the chemotherapy. The short-term effect, incidence of toxic and side reactions, three-year survival rate and five-year survival rate were compared between two groups. Results The complete response （CR） rate and pathologic complete response （pCR） of TNBC group aider neoadjuvant chemotherapy were higher than those of non-TNBC group, with statistical difference （P 〈0.05）, but the total effective rate of two groups had no statistical difference （P 〉0.05）. The main side effects of two groups were nausea and vomiting, leukopenia, bone marrow suppression, gastrointestinal tract reaction, alopecia and heart toxicity, and no statistical difference were found in two groups （P〉0.05）. The three-year survival rate of TNBC group was lower than that ofnon-TNBC group （74.2% vs 86.7%）, the five-year survival rate of patients who achieved pCR in TNBC group was higher than that of patients who didn＇t achieve pCR （85.7% vs 41.2%, P 〈0.05）. Conclusions Epirubicin, cyclophosphamide combined with docetaxel neoadjuvant chemotherapy can increase the CR rate and pCR rate in treatment of patients with TNBC, with tolerable toxicity, which can be served as preferred neoadjuvant chemotherapy method for TNBC patients.