新辅助化疗方案对乳腺癌患者不良反应及生活质量的影响

Influence of Neoadjuvant Chemotherapy on Side Effects and Quality of Life in Patients with Breast Cancer

目的 研究新辅助化疗方案对乳腺癌患者不良反应及生活质量的影响。方法 选取2013年10月至2014年10月达州市中心医院收治的126例乳腺癌患者为研究对象,按照随机数字表法分为观察组和对照组,各63例。观察组采用新辅助化疗方案（卡培他滨联合多西他赛）,予以患者2000 mg/m2的卡培他滨口服,早晚各1次;同期服用维生素B690 mg/d,早晚各1次,维持服用14 d;将80 mg/m2的多西他赛和0.9%氯化钠注射液稀释为300 m L,在化疗的第2日予以患者静脉滴注。对照组采取常规CEF方案（表柔比星、氟尿嘧啶、环磷酰胺）,将500 mg/m2的环磷酰胺和0.9%氯化钠注射液稀释为300 m L,50 mg/m2表柔比星和0.9%氯化钠注射液稀释为250 m L,在化疗的第1日和第8日予以患者静脉滴注,氟尿嘧啶300 mg/m2,在化疗第1日予以患者静脉滴注。1个周期为25 d,患者均化疗3~4个周期。观察比较两组患者的不良反应发生情况,治疗效率和生存率,生活质量改善情况。结果 观察组皮肤反应、骨髓抑制及胃肠道反应率均低于对照组[31.8%（20/63）比52.4%（33/63）,11.1%（7/63）比27.0%（17/63）,19.0%（12/63）比36.5%（23/63）],差异有统计学意义（P〈0.05）。观察组总有效率和生存率高于对照组[73.0%（46/63）比50.8%（32/63）;82.7%（52/63）比69.5%（43/63）],差异有统计学意义（P〈0.05）。治疗后,观察组生理状况、功能状况分、情感状况、社会状况评分低于对照组[（6.9±1.1）分比（8.6±1.2）分,（8.5±1.5）分比（10.9±1.6）分,（8.7±1.2）分比（10.8±1.2）分,（9.3±1.5）分比（11.6±2.0）分],差异有统计学意义（P〈0.01）。结论 新辅助化疗方案治疗乳腺癌患者预后效果良好,不良反应发生率较低,能够有效改善患者的临床症状与生活质量,提高患者生存率,帮助患者尽早地恢复身心健康。

Objective To study the influence of neoadjuvant chemotherapy on side effects and quality of life in patients with breast cancer. Methods Total of 126 cases of breast cancer in Dazhou Central Hospital from Oct. 2013 to Oct. 2014 were included in the study,according to a random number table they were divided into an observation group and a control group,63 cases each. The observation group was given XT program neoadjuvant chemotherapy（ capecitabine and docetaxel）,2000 mg / m2 capecitabine for oral,vitamin B6,90 mg / d,once in the morning and once at night,for 14 d; 80 mg / m2 of docetaxel and 0. 9% sodium chloride diluted to 300 m L,administered by intravenous drip on the second day of the scheme. The control group was given a conventional scheme CEF（ epirubicin,fluorouracil,cyclophosphamide）,500 mg / m2 of cyclophosphamide and 0. 9% sodium chloride diluted to 300 m L,50 mg / m2 epirubicin and 0. 9% sodium chloride diluted to 250 m L,administered on the first and eighth day by intravenous drip. A cycle was 25 d,all patients received 3-4 chemotherapy cycles. The side effects,therapeutic efficacy and survival,quality of life of the two groups were observed and compared. Results Skin reactions,myelosuppression and gastrointestinal reactions rate of the observation group were lower than the control group[31. 8%（ 20 /63） vs 52. 4%（ 33 /63）,11. 1%（ 7 /63） vs 27. 0%（ 17 /63）,19. 0%（ 12 /63） vs 36. 5%（ 23 /63） ],the differences were statistically significant（ P〈0. 05）. Total effective rate and survival rate of the observation group were higher than the control group[73. 0%（ 46 /63） vs 50. 8%（ 32 /63）; 82. 7%（ 52 /63） vs 69. 5%（ 43 /63） ],the differences were statistically significant（ P〈0. 05）. After treatment,the physiological conditions,functional status points,emotional status,social status score of the observation group were lower than the control group[（ 6. 9 ± 1. 1） scores vs（ 8. 6 ± 1. 2） scores,（ 8. 5 ± 1. 5） scores vs（ 10. 9 ± 1. 6） scores,（ 8. 7 ± 1. 2）scores vs（ 10. 8 ± 1. 2） scores,（ 9. 3 ± 1. 5） scores vs（ 11. 6 ± 2. 0） scores],the differences were statistically significant（ P〈0. 01）. Conclusion For the treatment of breast cancer patients neoadjuvant chemotherapy has good prognosis,low adverse effect rate,which can effectively improve the clinical symptoms and quality of life of the patients and improve the survival rate,helping patients recover physical and mental health earlier.