新辅助化疗周疗模式治疗晚期乳腺癌

Clinical efficacy observation of local advanced breast cancer with weekly neoadjuvant chemotherapy

目的回顾性分析表柔比星和环磷酰胺联合紫杉醇周疗用于晚期乳腺癌新辅助化疗的疗效及安全性。方法收集2017年10月1日—2019年9月30日山东省成武县人民医院乳甲外科收治的晚期乳腺癌患者76例,采用静脉滴注紫杉醇80 mg/m^2(7d/次)、表柔比星600 mg/m^2(1d/次)、环磷酰胺500 mg/m^2(1 d/次)进行化疗,21天为1周期,新辅助化疗3个周期后进行手术,术后常规依照《NCCN指南》规定剂量进行放射治疗。依据实体瘤疗效评价标准(RECIST1.1)判断疾病进展,不良反应依照WHO抗癌药物不良反应标准分度进行评价。结果周疗模式完成率86.1%,其中完全缓解(CR)患者32例(42.1%),部分缓解(PR)患者36例(47.4%),疾病稳定(SD)患者7例(9.2%),疾病进展(PD)患者1例(1.3%)。在治疗期,全组患者均未出现充血性心力衰竭,从血液学毒性、恶心呕吐等级、乏力、口腔炎症和腹泻等5个方面观察患者相关副反应,虽然患者大都出现了不同类型的不良反应,但发生率均少于其他文献报道,未出现Ⅳ级恶心呕吐现象。结论回顾性分析利用表柔比星和环磷酰胺联合紫杉醇周疗的新辅助化疗方法有利于晚期乳腺癌患者的预后,并且在术前化疗阶段患者对于不良反应的耐受较好。

Objective:To evaluate the efficacy and safety of neoadjuvant chemotherapy with paclitaxel administered weekly combined with epirubincin and cyclophosphamide regimen in advanced breast cancer.Methods:From October 1,2017 to September 30,2019,76 patients with advanced breast cancer diagnosed after pathological examination were admitted to the Department of Nail Surgery,Chengwu County People's Hospital,Shandong Province,and paclitaxel was administered intravenously at.80 mg/m^2(7 d/time),epirubicin 600 mg/m^2(1 d/time)and cyclophosphamide 500 mg/m^2(1 d/time)in the chemotherapy after admission with 21 days as a cycle.Surgery was performed after 3 cycles of neoadjuvant chemotherapy,and radiation therapy was routinely performed in accordance with the NCCN guidelines.According to the solid tumor efficacy evaluation standard(RECIST1.1),the disease progression and adverse reactions of the patients were evaluated according to the WHO standard anti-cancer drug adverse reactions.Results:The completion rate of weekly treatment mode was 86.1%,including 32 patients with complete response(42.1%),36 patients with progressive disease(47.4%),7 patients with stable disease(9.2%),one patient with progressive disease(1.3%).During the treatment period,no congestive heart failure occurred in the entire group of patients,and related adverse reactions were observed from 5 aspects including hematological toxicity,nausea and vomiting levels,fatigue,oral inflammation and diarrhea,although most patients had different types of adverse reactions,but all levels of the status were less than those reported in other literatures,and gradeⅣnausea and vomiting did not appear.Conclusion:Retrospective analysis of neoadjuvant chemotherapy using epirubicin and cyclophosphamide combined with paclitaxel week treatment is beneficial to the prognosis of patients with advanced breast cancer,and patients tolerate adverse reactions during preoperative chemotherapy.