新辅助化疗联合改良根治术治疗三阴性乳腺癌的临床效果

Clinical effect of neoadjuvant chemotherapy combined with modified radical mastectomy in the treatment of triple-negative breast cancer

目的探讨新辅助化疗(NAC)后三阴性乳腺癌(TNBC)患者选择改良根治术(MRM)的临床疗效。方法回顾性分析2018年6月至11月沧州市中心医院收治的40例乳腺癌患者的临床资料,根据治疗方法的不同将患者分为两组,每组各20例。对照组采用单纯MRM,观察组采用NAC后MRM。比较两组近期临床疗效(住院天数、术中出血量及手术时间)、3年内远处转移率与局部复发率、术后并发症发生率以及1年后客观缓解率(ORR)。结果观察组的手术用时[(49.80±6.19)min vs.(80.40±7.83)min]以及住院天数[(7.85±1.35)d vs.(12.45±2.11)d]均短于对照组,术中出血量少于对照组[(131.55±10.39)ml vs.(240.55±15.29)ml],术后并发症发生率低于对照组(5.0%vs.40.0%),3年内远处转移及局部复发率均低于对照组,1年后的ORR高于对照组,差异均有统计学意义(P<0.05)。结论TNBC患者选择NAC联合MRM方案,有利于提高近期疗效及改善预后,值得推广应用。

Objective To investigate the clinical efficacy of modified radical mastectomy(MRM)in patients with triple-negative breast cancer(TNBC)after neoadjuvant chemotherapy(NAC).Methods Retrospective analysis of the clinical data of 40 cases of breast cancer in Cangzhou Central Hospital from June to November 2018 was conducted.According to the different treatment methods,the patients were divided into two groups,20 cases in each group.The control group used MRM alone,the observation group used MRM after NAC.The short-term clinical efficacy(number of days in hospital,intraoperative blood loss and operation time),the probability of distant metastasis and local recurrence within 3 years and postoperative complication rate and objective response rate(ORR)after one year between the two groups were compared.Results The operation time([49.80±6.19]min vs.[80.40±7.83]min)and the number of days in hospital([7.85±1.35]d vs.[12.45±2.11]d)of the observation group were shorter than those of the control group,the intraoperative blood loss([131.55±10.39]ml vs.[240.55±15.29]ml)was less than that of the control group,the incidence rate of postoperative complications(5.0%vs.40.0%)was lower than that of the control group,the rates of distant metastasis and local recurrence within 3 years were lower than those of the control group,the ORR after one year was higher than that of the control group,and the differences were statistically significant(P<0.05).Conclusion The choice of NAC combined with MRM for TNBC patients is conducive to improving the short-term efficacy and prognosis,and it is worthy of popularization and application.