CAJ | 학술논문

目的：评估多西他赛与表柔比星的化学药物治疗（化疗）组合对局部晚期乳腺癌（ locally advanced breast cancer ， LABC）的预后影响。方法回顾分析沈阳军区总医院2009-01至2012-12接受新辅助化疗（ neoadjuvant chemotherapy ，NACT）的120例LABC患者，收集入选患者的基本信息、临床分期、雌激素和孕激素受体状态等指标。联合用药方案（联合组）为6个DEC周期（每周第1、3天联合使用多西他赛75 mg/m2，表柔比星75 mg/m2，环磷酰胺500 mg/m2）；序贯用药方案（序贯组）为4个FEC周期（5-氟尿嘧啶600 mg/m2，表柔比星75 mg/m2，环磷酰胺600 mg/m2），以及4个多西他赛（85 mg/m2）周期。统计两组患者的临床和病理缓解情况、复发时间及3年生存率。结果患者平均年龄46岁。 T4期肿瘤患者96例（80％），其中90％可触及淋巴结。原发肿瘤平均大小为5．9 cm。激素受体阳性患者占55％，HER2阳性患者占25％，三阴乳腺癌患者占25％。两组中临床完全或部分缓解的有100例，占83％，疾病稳定15例，疾病进展5例；病理缓解18例，占15％。两种给药方式所获得的临床及病理缓解率无统计学差异。随访期平均为22个月，平均复发时间20个月，3年无复发病例占50％，3年生存率70％，两组间无明显差异。联合组有5例患者死于毒性反应，15％患者有伴发热的中性粒细胞减少症。结论 NACT可以改善LABC患者预后，序贯化疗方案患者耐受性较好。
목적：평고다서타새여표유비성적화학약물치료（화료）조합대국부만기유선암（ locally advanced breast cancer ， LABC）적예후영향。방법회고분석침양군구총의원2009-01지2012-12접수신보조화료（ neoadjuvant chemotherapy ，NACT）적120례LABC환자，수집입선환자적기본신식、림상분기、자격소화잉격소수체상태등지표。연합용약방안（연합조）위6개DEC주기（매주제1、3천연합사용다서타새75 mg/m2，표유비성75 mg/m2，배린선알500 mg/m2）；서관용약방안（서관조）위4개FEC주기（5-불뇨밀정600 mg/m2，표유비성75 mg/m2，배린선알600 mg/m2），이급4개다서타새（85 mg/m2）주기。통계량조환자적림상화병리완해정황、복발시간급3년생존솔。결과환자평균년령46세。 T4기종류환자96례（80％），기중90％가촉급림파결。원발종류평균대소위5．9 cm。격소수체양성환자점55％，HER2양성환자점25％，삼음유선암환자점25％。량조중림상완전혹부분완해적유100례，점83％，질병은정15례，질병진전5례；병리완해18례，점15％。량충급약방식소획득적림상급병리완해솔무통계학차이。수방기평균위22개월，평균복발시간20개월，3년무복발병례점50％，3년생존솔70％，량조간무명현차이。연합조유5례환자사우독성반응，15％환자유반발열적중성립세포감소증。결론 NACT가이개선LABC환자예후，서관화료방안환자내수성교호。
Objective To assess the response rates ( clinical and pathological ) with docetaxel and epirubicin combination chem-otherapy and its effect on outcome .Methods Locally advanced breast cancer ( LABC) patients who received NACT from January 2009 to December 2012 in this hospital were retrospectively analysed .Some information of the patients was collected including basic informa-tion, clinical stages and the situation of estrogen receptor and progesterone receptor .The regimens used for NACT consisted of six cycles of DEC (docetaxel 75 mg/m2, epirubicin 75 mg/m2, cyclophosphamide 500 mg/m2 on day 1, 3 weekly) and a sequential regimen (4 cy-cles of FEC, 5-flurouracil 600 mg/m2 , epirubicin 75 mg/m2 , cyclophosphamide 600 mg/m2 followed by 4 cycles of docetaxel 85 mg/m2 ) .Clinical response and pathological response rates , time of relapse and 3 year survival rate were assessed .Results The median age was 46 years.Ninety-six patrents (80%) had T4 disease and 90%had clinically palpable lymph nodes at diagnosis .The median size of primary tumor at presentation was 5.9 cm.Hormone receptor positivity was seen in 55%of patients and HER2/neu positivity in 25%. Triple negative breast cancers constituted of 25%of the patients.Totally 100 cases showed clinical response , accounting for 83%;15 ca-ses showed clinical stability;5 cased showed clinical progress .18 cases showed pathological response .There were no significant differ-ences between the two groups in the above data .The median duration of follow-up was 22 months.The median time to relapse was 20 months;3 year relapse free and overall survival rates were 50%and 70%, respectively .The differences between the two groups was not statically significant .Conclusions LABC patients have good outcome after neoadjuvant chemotherapy .Sequential chemotherapy is well tolerated than concurrent docetaxel and epirubicin chemotherapy with a similar PCR ( pathological complete response ) .