EC-T序贯和ET方案新辅助化疗在ⅡB～ⅢC期乳腺癌患者中的临床效果对比及对毒副反应发生率的影响研究

Comparison of clinical efficacy of EC-T sequential and ET regimen neoadjuvant chemotherapy in patients with stage ⅡB-ⅢC breast cancer and its effect on the incidence of toxic and side reaction

目的探讨EC-T序贯和ET方案新辅助化疗在ⅡB～ⅢC期乳腺癌患者中的临床效果及毒副反应。方法选取本院2009年1月～2015年6月诊治的ⅡB～ⅢC期乳腺癌患者60例,采用随机数字表法分为两组,对照组患者30例实施ET方案新辅助化疗,观察组患者30例实施EC-T序贯新辅助化疗,比较两组患者的临床效果、整体功能生命质量、毒副反应、预后。结果两组患者治疗后整体功能生命质量评分(躯体功能、角色功能、情感功能、认知功能、社会功能、整体生命质量)较治疗前显著增加(P <0.05)。观察组患者治疗后整体功能生命质量评分(躯体功能、角色功能、情感功能、认知功能、社会功能、整体生命质量)高于对照组(P <0.05)。观察组患者手术时间短于对照组(P <0.05)。观察组患者术中出血量、淋巴结阳性数、淋巴切除数量少于对照组(P <0.05)。观察组患者肿瘤最大直径小于对照组(P <0.05)。观察组患者有效率、疾病控制率、病理完全缓解率高于对照组(P <0.05)。观察组患者毒副反应(中性粒细胞减少、恶心呕吐、发热、腹泻)发生率显著低于对照组(P <0.05)。两组患者毒副反应(白细胞下降、血小板下降、脱发、肝功能损害、心肌损害)、预后(1年生存率、2年生存率、3年生存率)比较,差异均无统计学意义(P> 0.05)。结论与ET方案相比,EC-T序贯新辅助化疗可提高ⅡB～ⅢC期乳腺癌患者的治疗效果,降低毒副反应发生率,并改善整体功能生命质量,值得临床推广使用。

Objective To investigate the clinical efficacy of EC-T sequential and ET regimen neoadjuvant chemotherapy in patients with stage IIB-IIIC breast cancer and its effect on the incidence of toxic and side reaction.Methods Sixty patients with stageⅡB-ⅢC breast cancer in our hospital from January2009to June2015were selected,and divided into two groups by random number table method.30patients in the control group were received ET regimen neoadjuvant chemotherapy,30patients in the observation group were received EC-T sequential neoadjuvant chemotherapy.Clinical effects,overall functional quality of life,toxic and side reaction,prognosis were compared between the two groups.Results Overall functional quality of life scores(somatic function,role function,emotional function,cognitive function,social function,overall quality of life)of the two groups were significantly higher than those before the treatment(P<0.05).Overall functional quality of life scores(somatic function,role function,emotional function,cognitive function,social function,overall quality of life)in the observation group were higher than the control group after the treatment(P<0.05).Operative time in the observation group was shorter than the control group(P<0.05).Intraoperative blood loss,number of positive lymph nodes,number of lymphatic excision in the observation group were less than the control group(P<0.05).Maximum diameter of tumor in the observation group was smaller than the control group(P<0.05).The effective rate,disease control rate,pathological complete remission rate in the observation group were higher than the control group(P<0.05).Incidences of toxic and side reaction(neutropenia,nausea and vomiting,fever,diarrhea)in the observation group were lower than the control group(P<0.05).There were no significant differences in toxic and side reaction(leukocytopenia,thrombocytopenia,alopec ia,liver function damage,myocardial damage)and prognosis(1-year survival rate,2-year survival rate,3-year survival rate)between the two groups(P>0.05).Conclusion Compared with the ET regimen,EC-T sequential neoadjuvant chemotherapy can improve the therapeutic effect of patients with stageⅡB-ⅢC breast cancer,reduce the incidence of toxic and side effects,and improve the overall functional quality of life,which is worthy of clinical promotion.