不同辅助化疗对乳腺癌术后无病存活期及耐受性影响比较

Effects of different adjuvant chemotherapy on disease-free survival and tolerance in patients with breast cancer

目的比较不同辅助化疗对可手术乳腺癌患者无病存活期及耐受性的影响。方法以本院确诊的104例可手术乳腺癌患者为研究对象,随机分为两组,行TAC辅助化疗60例作为TAC组,行FAC辅助化疗44例作为FAC组,比较两组近期疗效、毒副反应及手术情况。随访3年,比较两组局部复发、远处转移及无病生存期。结果 TAC组近期缓解率(86.7%)显著高于FAC组(68.2%)(P<0.05)。TAC组白细胞减少Ⅲ~Ⅳ级发生率明显高于FAC组(P<0.05),两组间其他毒副反应无统计学差异(P>0.05)。两组保乳切除术构成比无统计学差异(P>0.05)。随访期间,TAC组远处转移率(10.0%)显著低于FAC组(25.0%)(P<0.05);两组局部复发、无病存活期无统计学差异(P>0.05)。结论 TAC化疗方案较FAC化疗方案近期缓解率明显提高,远处转移率显著降低,但无病存活期方面无显著差异。虽TAC化疗方案不良反应较FAC多,但多可控、且耐受性较好。

Objective To compare the effects of different adjuvant chemotherapy on disease-free survival and tolerance in patients with operable breast cancer. Methods A total of 104 patients with operable breast cancer were selected as the research subjects and were randomly divided into two groups to receive TAC adjuvant chemotherapy （TAC group, n =60） and FAC adjuvant chemotherapy （FAC group, n=44）. The clinical efficacy, adverse reaction and operation between the two groups were compared. After three years＇ follow-up visit, the local recurrence, distant metastasis and disease-free survival between the two groups were compared. Results The short-term remission rate （86.7%） in TAC group was significantly higher than that in group FAC （68.2%） （P 〈 0.05）. The incidence rate of Grade Ⅲ-Ⅳ level white blood cell decrease in TAC group was significantly higher than that in FAC group （P 〈 0.05）. There were no significant differences in toxic reaction and adverse reactions between the two groups （P 〉 0.05）, so did the constituent ratio for breast conserving surgery （P〉 0.05）. During the follow-up visit, the distant metastasis （10.0%） in TAC group was significantly lower than that in FAC group （25.0%） （P 〈 0.05）. There were no significant differences in local recurrence and disease- free survival between the two groups （P 〉 0.05）. Conclusion Compared with FAC chemotherapy regimen, the short-tenn remission rate of TAC chemotherapy regimen is significantly improved, and the distant metastasis rate is significantly lower, while there is no significant difference in disease-free survival rate between them. Although the adverse reaction of TAC regimen was more than that of FAC, it can be mostly controllable and has better tolerance.