密集AC序贯密集紫杉醇新辅助化疗对三阴性乳腺癌的近期疗效

Efficacy of Neoadjuvant Chemotherapy with Dose-dense ACPaclitaxel Regimen for Patients with Triple-Negative Breast Cancer

[目的]观察密集AC序贯密集紫杉醇新辅助化疗方案对三阴性乳腺癌的近期疗效及安全性。[方法]回顾性分析浙江省丽水市中心医院2012年3月至2015年12月间收治的经空芯针活检及免疫组化确诊为三阴性乳腺癌患者的临床资料47例。术前给予多柔比星联合环磷酰胺4周期化疗,之后序贯密集紫杉醇4周期新辅助化疗方案。根据RECIST实体瘤疗效评价标准及术后病理组织学检查评价疗效,依据WHO抗癌药物不良反应的分度标准评价药物的不良反应。[结果]47例患者中均完成全部周期化疗,总有效率为85.1%（40/47）,临床完全缓解率为46.8%（22/47）,病理完全缓解率为42.6%（20/47）。不良反应中骨髓抑制Ⅰ度、Ⅱ度、Ⅲ度分别有21、6、3例,胃肠道反应Ⅰ度、Ⅱ度、Ⅲ度分别有25、5、2例,肝功能异常4例,心脏毒性2例,神经毒性27例,脱发40例,感染10例,无严重危及生命的并发症出现。[结论]密集AC序贯密集紫杉醇新辅助化疗方案对三阴性乳腺癌的近期疗效较好,不良反应可耐受,值得临床进一步研究。

[Objective]To assess the efficacy and safety of neoadjuvant chemotherapy with dosedense AC-paclitaxel regimen in treatment of patients with triple-negative breast cancer（TNBC）.[Methods]The clinical date of 47 patients with TNBC,confirmed by core needle biopsy combined with immunohistchemistry,admitted in Lishui Municipality Central Hospital from March 2012 to December 2015 were retrospectively analyzed.The regimen containing 4 cycles of doxorubicin with cyclophosphamide and then sequential dose-dense paclitaxel for 4 cycles chemotherapy before surgery.Standard RECIST guidelines and postoperative histopathological examination were used to evaluate clinical and pathological response.The adverse drug reactions were evaluated based on the criteria of WHO adverse drug reactions.[Results]Forty seven patients completed all cycles of chemotherapy.The total response rate was 85.1%（40/47）,clinical complete remission was 46.8%（22/47）,pathological complete remission was 42.6%（20/47）.There were 21,6,3 cases of degree Ⅰ and Ⅱ,Ⅲ bone marrow suppression,25,5,2 cases of degree Ⅰ and Ⅱ,Ⅲ gastrointestinal reaction,4 cases of abnormal liver function,2 cases of cardiac toxicity,27 cases of neurotoxicity,40 cases of alopecia,10 cases of infection,and no life-threatening complications.[Conclusion]Dose-dense paclitaxel followed dose-dense AC regimen has good curative effect with tolerated adverse reactions for triple-negative breast cancer.