THP为主的联合方案治疗Ⅱ～Ⅲ期乳腺癌新辅助治疗的临床观察

Clinical Observation of the Efficacy of Pirarubicin (THP)-based Combination Therapy in Neoadjuvant Treatment for Stage Ⅱ～Ⅲ Breast Cancer

目的探讨分析吡柔比星(THP)为主的联合方案治疗Ⅱ~Ⅲ期乳腺癌新辅助治疗中疗效观察。方法回顾性分析2011年2月至2012年3月期间我院收治96例Ⅱ~Ⅲ期乳腺癌患者的临床诊断、治疗以及预后,47例对照组患者采用多西他赛静脉注射,49例观察组患者采用吡柔比星(THP)联合多西他赛静脉注射,观察并比较两组患者治疗后2 w与4w的临床疗效及预后效果,随访中比较两组患者的生存率和基本复发情况。结果观察组患者治疗后2 w临床总有效率(77.55%)、治疗后4 w临床总有效率(79.59%)和对照组的(53.19%、57.45%)相比明显较高,差异具有统计学意义(P<0.05)。观察组6个月、1年的近期肿瘤复发率与观察组相近,差异无具有统计学意义(P>0.05),但观察组肿瘤远期复发率(18.37%)与对照组(38.30%)相比明显要低,差异具有统计学意义(P<0.05);观察组患者6个月无病生存率(95.92%)、1年无病生存率(91.84%)及5年无病生存率(80.63%)均显著明显高于对照组患者6个月无病生存率(82.98%)、1年无病生存率(74.47%)及5年无病生存率(63.83%),差异具有统计学意义(P<0.05)。结论以THP为主的联合方案治疗Ⅱ~Ⅲ期乳腺癌新辅助治疗,采用THP联合多西他赛静脉注射的治疗方式,对Ⅱ~Ⅲ期乳腺癌的治疗效果更为显著,有效改善患者预后生存率及远期肿瘤复发率。

Objective To investigate the efficacy of pirarubicin（ THP）-based combination therapy in neoadjuvant treatment for stageⅡ ~ Ⅲ breast cancer. Methods A retrospective analysis of 96 patients＇ clinical diagnosis,treatment and prognosis was carried out,who were with stageⅡ ~ Ⅲ breast cancer and treated from February 2011 to March 2012 in our hospital. 47 patients in the control group were treated with docetaxel intravenous injection,and 49 cases in the observation group were treated with pirarubicin（ THP）combined with docetaxel intravenous injection. The clinical efficacy and prognosis two weeks and four weeks after treatment of the two groups were observed and compared. The survival rate and the recurrence rate of the two groups were also compared. Results The clinical total efficiency in the observation group after two weeks（ 77. 55%） and four weeks（ 79. 59%） were both significantly higher than those in the control group,which were 53. 19% and 57. 45% respectively,with statistically significant differences（ P0. 05）.The recurrence rate of the observation group in six months and a year was close to that in the observation group,and the difference was statistically insignificant（ P0. 05）. However,the long-term recurrence rate of the observation group（ 18. 37%） was significantly lower than that of the control group（ 38. 30%）,and the difference was of statistical significance（ P0. 05）. The six-month disease-free survival rate（ 95. 92%）,the one-year disease-free survival rate（ 91. 84%） and the five-year disease-free survival rate（ 80. 63%） of the patients in the observation group were significantly higher than those in the control group,which were 82. 98%,74. 47% and 63. 83% respectively. The differences were of statistical significance（ P0. 05）. Conclusion Neoadjuvant treatment of stage Ⅱ - Ⅲ breast cancer with THP-based combination therapy,THP combined with docetaxel intravenous injection,proves to be more efficient. It can improve the prognosis of patients with long-term survival rate and decease tumor recurrence rate.