TC对比ET治疗晚期三阴性乳腺癌的临床观察

TC Contrast ET in the Three Negative Treatment of Advanced Breast Cancer Clinical Observation

目的通过对比分析新辅助化疗TC与TE方案治疗三阴性乳腺癌(TNBC)的疗效和安全性。方法 78例三阴性乳腺癌患者均经病理学确诊,分为TC组(39例)和TE组(39例)。TC组:多西他赛75mg/m^2或紫杉醇175 mg/m^2iv,d1;卡铂(AUC=5)IV d2,q21d×4~6周期。ET组:表柔比星90 mg/m^2iv,分d1,2+多西他赛75mg/m^2或紫杉醇175mg/m^2iv,d3,q21d×4~6周期。评价两组近期疗效和毒副反应。结果 TC组获pCR 12例(30.77%),CR 5例(12.82%),PR 30例(70.92%),SD 3例(7.69%),PD 1例(2.57%)ORR为89.74%;ET组获pCR 4例(10.25%),CR 4例(10.25%),PR 27例(69.23%),SD 7例(17.95%),PD 1例(2.57%),ORR为79.48%。两组的客观缓解率相似,分别89.74%(35/39)和ORR为79.48%(31/39),P=0.209,但两组pCR率有显著统计学差异,分别为30.77%(12/39)和10.25%(4/39),P=0.025(P<0.05)。两组方案的耐受性均较好,TC和ET两组最常见的不良反应为中性粒细胞减少(82.05%Vs 74.36%,P=0.411)和恶心呕吐(79.49%Vs 76.92%,P=0.830),其中3/4级中性粒细胞减少(69.23%Vs 61.54%,P=0.475)和恶心呕吐(2.56%Vs5.13%,P=0.556)发生率相似。TC组血小板减少的发生率较ET组高(38.46%Vs 5.13%,P<0.001),3/4级的发生率无显著差异(5.13%Vs0%,P=0.152)。结论与临床上最常用的ET方案相比,TC方案可明显提高TNBC患者的pCR率,两组方案耐受性好,无统计学差异。TC方案可以作为TNBC较为优选的新辅助化疗方案。

Objective through the comparative analysis of new adjuvant chemotherapy TC and ET, the curative effect of treatment of three negative breast cancer（TNBC）, and security. Methods 78 cases of three negative breast cancer patients were confirmed by pathology, is divided into TC group （39 cases） and the TE group （39 cases）. TC group： west he match 75 mg/m2 or 175 mg/m2iv taxol, dl ;Carboplatin （AUC = 5） IV d2, q21d x 4 to 6 cycles, ET groups： 90 mg/m2iv epirubicin, dl, 2 ＋ west he match more than 75 mg/mz or 175 mg/m2iv taxol, d3, q21d x4 to 6 cycles. Evaluation of two groups in the near future curative effect and ad- verse reaction. Results 12 cases by pCR TC group （30.77 % ）, CR in 5 cases （ 12.82 % ）, 30 cases （70.92 % ） PR, SD in 3 patients （7.69 %） and PD in 1 case （2.57 % ）, ORR is 89.74 %; ET group by pCR in 4 cases （10.25%）, CR 4 cases （10.25%）, PR 27 cases （69.23%）, SD 7 cases（17.95%）, and PD in 1 case （2.57 % ）, ORR 79.48 %, two groups are of a similar objective response rate were 89.74 % （35/39） and ORR was 79.48% （31/39）, P = 0. 209, but has a statistically significant difference between the two groups of pCRrate, 30.77 % （12/39） and 10.25 % （4/39）, P = 0. 025 （P 〈 0.05）. Better tolerabi!ity of the two groups, both of the TC and ET group of the most common adverse reactions as neutropenia（82.05 % Vs 74.36 %, P = 0. 411）, and nausea and vomiting （79.49 % Vs 76.92 %, P = 0. 830）, including grade 3/4 neutropenia （69.23 % Vs 61.54 %, P = 0. 475 ）, and nausea and vomiting incidence （Vs 5.13 % 2.56 %, P = 0.556 ）. High TC is the incidence of thrombocytopenia ET group （38.46 % Vs 5.13 %, P 〈 0. 001 ）, no significant differences in preva- lence of 3/4 level（5.13 % Vs 0 %, P = 0.15 2）. Conclusion Compared with the most commonly used clinically ET scheme, TC solution can obviously improve the pCR rate of the patients with TNBC, two groups of good tolerance, no statistical difference. TC solution can be used as a TNBC relatively optimal neoadjuvant chemotherapy regimens.