早期化疗对乳腺癌根治术后患者临床预后的影响

Effect of early chemotherapy on the clinical prognosis in patients with breast cancer after radical mastectomy

目的探讨早期化疗对乳腺癌根治术后患者临床预后的影响。方法选取2013年2月至2015年2月间在辽宁省肿瘤医院行乳腺癌根治手术治疗的320例乳腺癌患者,采用随机数表法将患者分为早期组与常规组,每组160例。早期组患者术后3周内进行化疗治疗,常规组患者术后3~8周时进行化疗治疗。比较两组患者药物不良反应、2年复发率和2年生存率,并对早期化疗的相关预后因素进行单因素与多因素Cox分析。结果早期组患者2年复发率15.6%低于常规组31.3%,生存率91.9%高于常规组的78.1%,差异均有统计学意义(均P<0.05)。两组患者的血液系统、消化系统与肝肾功能不良反应比较,差异无统计学意义(P>0.05)。Cox单因素与多因素回归分析结果显示,TNM分期、肿瘤分化程度和淋巴结转移个数与乳腺癌根治术后早期化疗患者的预后有关,且为乳腺癌根治术后患者早期化疗的独立预后因素,差异均有统计学意义(均P<0.05)。结论乳腺癌根治术后患者早期化疗,可以有效延长患者的生存期,且不会增加不良反应,适于临床推广。

Objective To investigate the effect of early chemotherapy on the clinical prognosis in patients with breast cancer after radical mastectomy. Methods A total of 320 breast cancer patients who underwent radical mastectomy at Liaoning Tumor Hospital from February 2013 to February 2015 were selected and were randomly divided into an early group and a conventional group with 160 patients in each group. The conventional group received chemotherapy at 3 to 8 weeks after the operation,and the early group received chemotherapy within 3 weeks after the operation. The adverse drug effects,2-year recurrence and 2-year survival were compared between the two groups. The factors influencing the prognosis after early chemotherapy were analyzed by univariate and multivariate Cox analysis. Results The 2-year recurrence 15. 6% for the early group which was lower than 31. 3% of the conventional group（ P〈0. 05）,and the survival rate was91. 9% for the early group which was higher than 78. 1% of the conventional group（ all P〈0. 05）. There was no significant difference between the two groups of blood system,digestive system and liver and kidney function toxicity（ P〉0. 05）. Cox univariate and multivariate regression analysis showed that TNM staging,tumor differentiation and the number of lymph node metastasis were related to the prognosis in patients with early chemotherapy after radical mastectomy（ all P〈0. 05）,and they were independent prognostic factors for early chemotherapy after radical mastectomy. Conclusion Early chemotherapy after radical mastectomy can effectively prolong the survival period,without increasing the side effects,which is suitable for clinical application.