乳腺癌改良根治术联合新辅助化疗对乳腺癌患者的应用价值

Effect of modified radical mastectomy combined with neoadjuvant chemotherapy on breast cancer

目的探讨乳腺癌改良根治术联合新辅助化疗对乳腺癌患者的临床应用价值。方法选取2012年2月~2015年2月确诊的乳腺癌患者82例。根据简单数字表法随机将患者分为观察组41例和对照组41例。对照组采用常规改良根治术。观察组在手术前进行2~3个周期的化疗（1个周期为21d）,化疗药物主要由吡柔比星（THP）联合氟尿嘧啶（Fu）与环磷酰胺（CTX）组成。在第一天和第八天由静脉滴注550mg/m2 CTX和500mg/m2 Fu,同时在第一天静脉注射40mg/m2 THP。化疗完毕后再进行改良根治术。对比两组患者的手术时间、术中出血量、住院时间及1年后两组患者复发及生存情况;同时比较两组患者的术后并发症及术后生存质量。结果观察组的手术时间和术中出血量以及住院时间都显著少于对照组（P〈0.05）,复发率低于对照组（P〈0.05）,生存率高于对照组（P〈0.05）;观察组术后并发症少于对照组（P〈0.05）,生存质量高于对照组（P〈0.05）。结论改良根治术联合新辅助化疗治疗乳腺癌,可有效缩短手术时间,减少术中出血和术后并发症,提高临床疗效和患者生存质量,可在临床推广应用。

Objective To study clinical value of the breast cancer modified radical joint neoadjuvant chemotherapy in patients with breast cancer.Methods 82 paitents with breast cance were randomly divided into observation group（41cases）and control group（41patients）.The control group was treated with conventional modified radical mastectomy.Observation group was treated with conventional modified radical mastectomy before for 2or 3courses of chemotherapy.The chemotherapy drugs were mainly composed of pirarubicin,fluorouracil and cyclophosphamide.The operation time,intraoperative blood loss,hospital stay,the recurrence and survival rate 1year after operation,then postoperative complications and the quality of life of the patients were observed.Results The operative time,intraoperative blood loss and hospital stay of observation group were significantly less than that of control group.The recurrence rate of observation group was lower than that of control group.The survival rate of observation group was higher than that of control group.The differences had statistical significance（P0.05）.The incidence of postoperative complications of observation group was less than that of control group.The quality of life of observation group was higher than that of control group.The differences were statistical significant（P0.05）.Conclusion modified radical mastectomy combined with neoadjuvant chemotherapy has short operation time,few intraoperative bleeding,few postoperative complications and good curative effect.