Ⅲ期乳腺癌综合治疗的前瞻性研究

A randomized prospective study on combined treatment of patients with stage-Ⅲ breast cancer

目的 探讨提高Ⅲ期乳腺癌疗效的方法。方法 前瞻性随机分组 ,85例Ⅲ期乳腺癌患者分为 3组 ,A组 2 8例 (化疗 +手术 +放疗 ) ,放疗后配合辅助化疗 ;B组 2 8例 (手术 +化疗 +放疗 ) ;C组 2 9例 (手术 +放疗 +化疗 )。观察各组的 5年生存率、局部区域复发率和远处转移率差异有无显著性。结果 全部病例 5年生存率为 5 7 6 5 % ,局部区域复发率为 18 82 % ,远处转移率为18 82 %。各组 5年生存率分别为 75 0 0 %、5 3 5 7%、4 4 83% ,A组与C组比较差异有显著性 (P <0 0 5 )。各组局部区域复发率分别为 7 14 %、32 14 %、17 2 4 % ,其中A组与B组比较差异有显著性(P <0 0 5 )。各组远处转移率分别为 7 14 %、10 71%、37 93% ,A组与C组及B组与C组间比较差异均有显著性 (P <0 0 5 )。结论 术前化疗再手术配合术后放疗及辅助化疗可提高Ⅲ期乳腺癌疗效。

Objective To evaluate the curative effect of three different kinds of treatment for patients with stage-Ⅲ breast cancer. Methods Eighty patients with stage-Ⅲ breast cancer were randomized into three different groups:28 were treated by preoperative chemotherapy,combined with surgery and radiotherapy (group A);28 by surgery combined with chemotherapy and radiotherapy (group B);and 29 by surgery combined with radiotherapy and chemotherapy (group C).Differences in local regional recurrence,distant metastasis and 5-year survival rate were analysed for the three groups. Results The five-year survival rates were 57.65%,75.00%,53.57%,44.83% for the whole series and groups A,B,C,respectively.The difference was statistically significant between groups A and C ( P <0.05).The local regional recurrence rates were 18.82%,7.14%,32.14%,17.24% for the whole series and groups A,B,C,respectively.The difference was statistically significant between groups A and B ( P <0.05).The distant metastasis rates were 18.82%,7.14%,10.71%,37.93% for the whole series and groups A,B,C,respectively.The difference was statistically significant between groups A or B and C( P <0.05). Conclusion Preoperative chemotherapy plus surgery and followed by radiotherapy may improve the outcome of stage-Ⅲ breast cancer. ;