ALND术结合EC方案、3D-CRT对初诊时淋巴结转移乳腺癌患者的疗效及生存期的logistics分析

Logistics Analysis of the Effect of ALND Combined with EC and 3D-CRT on the Curative Effect of Breast Cancer Patients with Primary Lymph Node Metastasis

目的分析ALND术结合EC方案、3D-CRT对初诊时淋巴结转移乳腺癌患者的疗效及患者生存期的影响因素。方法以初诊时淋巴结转移乳腺癌患者60例为研究对象,按照随机分组原则,将以上患者随机分为观察组和对照组,每组30例,所有患者均采取ALND术结合EC方案治疗,观察组患者在此基础上联合采取3D-CRT治疗。结果观察组肿瘤控制率明显较高(P<0.05);两组患者的手术时间、淋巴结清扫数目、出血量、术后引流量以及住院时间差异不存在统计学意义(P>0.05);观察组患者的OS以及PFS显著高于对照组;两组患者出现上肢疼痛、上肢水肿、皮肤感觉迟钝情况差异不存在统计学意义(P>0.05);不同年龄、肿瘤最大径、TNM分期、ER状态情况的生存状态的差异存在统计学意义(P<0.05);肿瘤最大径、淋巴结转移数目在12以上,ER为阳性、TNM分期在Ⅲ期以上以及术后未放疗均为患者术后总生存期降低的独立危险因素。结论ALND术结合EC方案、3D-CRT对初诊时淋巴结转移乳腺癌患者的疗效显著,肿瘤最大径、淋巴结转移数目在12以上、ER为阳性、TNM分期在Ⅲ期以上以及术后未放疗均为患者术后总生存期降低的独立危险因素。

Objective To analyze the efficacy of ALND combined with EC regimen and 3D-CRT in patients with lymph node metastatic breast cancer at initial diagnosis and its impact on the survival time of patients with logistics analysis.Methods Sixty patients with lymph node metastatic breast cancer at initial diagnosis were included in the study.According to the principle of random grouping,the patients were randomly divided into the observation group and the control group,with 30 cases in each group.All patients were treated with ALND combined with EC regimen,and patients in observation group were treated with 3D-CRT on this basis.Results The tumor control rate in the observation group was significantly higher(P<0.05).There were no significant differences in operation time,number of lymph nodes dissected,blood loss,postoperative drainage volume and length of hospital stay between the 2 groups(P>0.05).The OS and PFS of the observation group were significantly higher than those of the control group.There was no significant difference in upper limb pain,upper limb edema and skin sensory retardation between the two groups(P>0.05).There were significant differences in survival status among different age,tumor maximum diameter,TNM stage and ER status(P<0.05).The maximum diameter of tumor,the number of lymph node metastases above 12,ER positive,TNM stage aboveⅢand no postoperative radiotherapy were independent risk factors for decreased overall survival.Conclusion ALND combined with EC regimen and 3D-CRT is effective in the treatment of breast cancer patients with lymph node metastasis at initial diagnosis.The maximum diameter of the tumor,the number of lymph node metastasis above 12,ER positive,TNM stage aboveⅢ,and no postoperative radiotherapy are independent risk factors for reduced overall survival.