乳腺癌新辅助化疗蒽环序贯紫杉方案剂量密集与三周方案的比较

Clinical Comparison of Neoadjuvant Chemotherapy Between Dose-Dense and Three-week EC-T Regimens in the Breast Cancer Patients

目的:比较剂量密集EC(表阿霉素+环磷酰胺)序贯T(紫杉醇)方案与三周EC序贯T(多西紫杉醇)方案用于乳腺癌新辅助化疗的疗效及毒副作用。方法:收集我院甲乳外科2015年1月至2017年1月40例接受EC-T方案新辅助化疗的II-III期原发性乳腺癌病例进行回顾性研究,根据化疗方案分为三周组30例,每3周为1个化疗周期,共8个疗程;剂量密集组10例,每2周为1个化疗周期,共8个疗程。按RECIST 1.1标准判断临床疗效,按照通用不良事件术语标准4.0版(CTCAE 4.0)评价毒副作用。结果:三周组及剂量密集组的有效率分别为70.0%和60.0%,组间有效率差异无统计学意义(P>0.05)。2组间主要不良反应粒细胞减少的差异也无统计学意义(P>0.05)。结论:三周及剂量密集方案用于乳腺癌新辅助化疗均有较好的疗效。相对于三周新辅助化疗,剂量密集型方案能明显缩短术前化疗时间,且毒副作用未增加。

[Objective]To compare the efficacy and toxicity between dose-dense and three-week neoadjuvant chemotherapy with epirubicin and cyclophosphamide followed by taxanes（EC-T）.[Method]A total of 40 patients with stage I-III primary breast cancer received neoadjuvant chemotherapy with EC-T from January 2015 to January 2017.30 of them received three-week regimen with three weeks per cycle for totally 8 cycles.10 of them received dose-dense regimen,two weeks per cycle of totally 8 cycles.The clinical efficacy was evaluated by ultrasound and caliber using RECIST（V1.1）criteria.The toxicity was evaluated according to Common Terminology Criteria Adverse Events Version4.0（CTCAE v4.0）.[Result]The objective response rate was 60.0%in DD group and70.0%in3 W group.No statistical difference was observed（P〉0.05）.The toxicity of the hematology showed no difference.[Conclusion]Both the three-week and dose-dense neoadjuvant chemotherapy could have an good efficacy.Contrast to three-week regimen,dose-dense regimen had shorter length time of chemotherapy and the toxicity was acceptable.