新辅助化疗ET方案联合扩张皮瓣对局限性晚期乳腺癌根治术患者的影响

Influence of Neoadjuvant Chemotherapy Combined with Expanded Skin Flap on Curative Effect and Life Quality of Patients with Localized Advanced Breast Cancer after Radical Operation

目的探讨新辅助化疗ET方案联合扩张皮瓣对局限性晚期乳腺癌(LABC)根治术患者的疗效及生存质量的影响。方法选取LABC患者96例,采取随机数字表法将其分为对照组与研究组,两组患者均实施乳腺癌根治术,对照组给予多西紫杉醇联合表阿霉素新辅助化疗,研究组在对照组基础上实施扩张皮瓣治疗,对比两组患者的美容疗效及生存质量水平,并对两组患者的局部复发率、转移率及生存率进行分析。结果研究组美容有效率为87.50%,显著高于对照组的68.75%,(P<0.05);两组患者心理因子、躯体因子、社会因子、信仰因子及生存质量总得分相比,差异有统计学意义(P<0.05);研究组局部复发率为2.83%、转移率为4.17%,明显低于对照组(8.33%,16.67%)(P<0.05);研究组5年生存率为75.00%,对照组为56.25%,差异有统计学意义(χ~2=5.245,P=0.006)。结论 LABC根治术患者行多西紫杉醇联合表阿霉素新辅助化疗及扩张皮瓣的效果较好,患者生存质量明显提高,值得临床推广应用。

Objective To explore the influence of neoadjuvant chemotherapy combined with expanded skin nap on curative effect and life quality of patients with localized advanced breast cancer （LABC） after radical operation. Methods A total of 96 patients with LABC in our hospital between June 2012 and November 2013 were selected and they were divided into control group and study group according to the random number table method. Patients in the two groups were given radical operation of breast cancer. Patients in the control group were given neoadjuvant chemotherapy of docetaxel combined with epirubicin, and those in the study group were given expanded skin flap on the basis of the control group. C0smetology rate, life quality level, local recurrence rate, metastasis rate, and survival rate were analyzed between the two groups. Results Cosmetology rate of patients in the study group was 87.50%, which was higher than that of the control group （68.75%）, the difference was significant （P 〈 0.05）. The psychological factors, physical factors, social factors, belief factors, and total scores of life qual- ity between the two groups were significant （P〈 0.05）. The local recurrence rate and metastasis rate were 2.83% and 4.17% respectively in the study group. Both were significantly lower than those in the control group （8.33% and 16.67%）, and the differences were significant （P〈0.05）. The 3-year survival rate of the study group was 66.67%, which was higher than that of the control group （50.00%） （P〈0.05）. Conclusion The effects of neoadjuvant chemotherapy of docetaxel combined with epirubicin is better for patients with locally advanced breast cancer. It significantly improved life quality of patients and is worthy of clinical popularization and application.