紫杉醇脂质体单周方案与传统方案在乳腺癌新辅助化疗中的治疗效果及不良反应比较

Comparison of the efficacy and adverse reactions of paclitaxel liposome mono-week regimen and traditional regimen in neoadjuvant chemotherapy for breast cancer

目的比较紫杉醇脂质体单周方案和传统方案在乳腺癌新辅助化疗中的治疗效果及不良反应。方法选取2016年10月至2017年10月于郑州大学第一附属医院住院治疗的乳腺癌患者64例,随机分为对照组(n=32例,3周方案)和试验组(n=32例,单周方案)。两组患者均采用表阿霉素和环磷酰胺序贯紫杉醇脂质体行新辅助化疗,表阿霉素和环磷酰胺4个周期后,试验组每周行紫杉醇脂质体化疗,共12周,对照组每21天化疗1次,共4个周期。化疗结束后1~2周,对两组化疗效果及不良反应进行分析。结果试验组和对照组患者的病理完全缓解率分别为40.6%和37.5%,有效率分别为87.5%和90.6%,差异未见统计学意义(P>0.05)。安全性分析显示,试验组的白细胞减少、恶心呕吐、神经毒性、脱发、末梢神经炎、口腔黏膜炎的发生率均低于多西紫杉醇组,差异均有统计学意义(P均<0.05)。结论紫杉醇脂质体单周方案与传统3周方案在乳腺癌新辅助化疗中作用效果相近,但单周方案不良反应较少,且程度较轻,安全性更高。

Objective To compare the efficacy and adverse reactions of paclitaxel liposome monotherapy and conventional 3-week regimen in neoadjuvant chemotherapy for breast cancer. Methods Sixty-four patients with breast cancer in the First Affiliated Hospital of Zhengzhou University from October 2016 to October 2017 were randomly divided into control group (n=32, 3-week plan) and the experimental group (n=32, weekly plan). The two groups received neoadjuvant chemotherapy with epirubicin and cyclophosphamide sequential paclitaxel liposomes. After four cycles of epirubicin and cyclophosphamide, the experimental group received paclitaxel liposomes chemotherapy weekly for 12 weeks. The control group received chemotherapy once every 21 days for four cycles. After 1 to 2 weeks of chemotherapy, the effects and adverse reactions of chemotherapy of the two groups were analyzed. Results The pathological complete remission rates were 40.6% and 37.5% in the experimental group and control group, respectively, and the effective rates were 87.5% and 90.6% respectively, there was no significant difference between the two groups (P>0.05). Safety analysis showed that the incidences of leukemic reduction, nausea and vomiting, neurotoxicity, alopecia, peripheral neuritis and oral mucositis in the experimental group were lower than those in the docetaxel group, and the differences were significant(P all<0.05). Conclusions The effect of paclitaxel liposome mono-week regimen is similar to that of conventional regimen on the neoadjuvant chemotherapy for breast cancer, but the adverse reactions of the mono-week regimen are less, mild, and more safe.