术前动脉灌注化疗辅助乳腺癌保乳手术的临床观察

Clinical observation of conservative surgical treatment combined with preoperative chemotherapy via intra-artery catheter in primary breast cancer

目的 探讨术前肱动脉插管灌注化疗在Ⅰ、Ⅱ期乳腺癌保留乳房手术 (BCT)中的作用。方法 采用肱动脉插管灌注表阿霉素 (EADR) 5 0～ 70mg/m2 、丝裂霉素 (MMC) 6～ 8mg/m2 、5 氟脲嘧啶 (5 Fu) 75 0～ 10 0 0mg/m2 共治疗 3 2例 ,其中Ⅰ期 8例 ,Ⅱ期 2 4例。结果 化疗后PR 2 3例 ,MR 7例 ,2例无变化 ,缓解率达 71.9%。Ⅱ期患者中有 18例肿瘤直径缩小到 2cm以下 ,获得BCT手术机会。Ⅰ期患者虽然可直接实施BCT手术 ,但考虑乳腺癌的多中心性及多灶性 ,作者认为术前化疗是有益的。 2 6例接受BCT手术的患者随访 1～ 5年 ,仅 1例出现局部复发。

Objective To assess the effect of preoperative chemotherapy via intra artery catheter in stage Ⅰ?Ⅱ breast carcinoma conservative surgical treatment.Methods From 1995 to 2000,in 32 patients EADR 50～70 mg/m 2,MMc 6～8 mg/m 2,5 Fu 750～1 000 mg/m 2 were infused into brachial artery via catheter preoperatively,including stage Ⅰ 18 cases,stage Ⅱ 24 cases.Results PR 23 cases,MR 7 cases and 2 cases had no change after chemotherapy,the PR rate was 71.9%.In 18 cases of stage Ⅱ,the diameter of tumor shrunk to be smaller than 2 cm and therefore were given BCT.Patients of stage Ⅰ could be treated primarily by BCT,but considering the characteristic of poly center of breast carcinoma,preoperative chemotherapy should be benefitial.26 cases receiving BCT were followed up for 1 year to 5 years.Recurrence was found in only 1 case.Conclusion Preoperative chemotherapy via in tra artery catheter can let the patients of stage Ⅱ breast cancer gain the possibility of BCT.