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[目的]观察多西紫杉醇联合表柔比星(TE)新辅助化疗治疗老年局部晚期乳腺癌(LABC)的客观缓解率、手术切除率及毒副反应。[方法]2005年10月至2008年8月,30例经空芯针活检组织学诊断证实的老年LABC行TE方案新辅助化疗,Ⅲa期17例,Ⅲb期11例,Ⅲc期2例,中位年龄74岁;化疗剂量为:多西紫杉醇75mg/m2,d1静滴,表柔比星60mg/m2,d1静滴,每3周为1个周期;2个周期TE方案之后对病灶进行首次评估,以决定是否再给予1～2个周期TE后再接受手术或放射治疗。[结果]30例患者接受2～4个周期TE方案的新辅助化疗,25例降低了临床分期,降期率为75.0%(25/30);临床完全缓解率(CCR)及临床部分缓解率(CPR)分别为23.3%(7/30)、53.3%(16/30);手术切除率为96.7%(29/30)。常见毒副反应有:中性粒细胞减少症、轻中度脱发、恶心、呕吐、体液潴留、肌肉关节疼痛等。Ⅲ、Ⅳ度中性粒细胞减少症分别为23.3%(7/30)和3.3%(1/30)。[结论]TE方案新辅助化疗治疗老年LABC患者是安全有效的,可以降低临床分期,提高患者术后的生活质量。
[Objective] To observe the objective response rate, surgical resection rate and toxicity of docetaxel combined with epirubicin (TE) neoadjuvant chemotherapy in the treatment of advanced locally advanced breast cancer (LABC). [Methods] From October 2005 to August 2008, 30 cases of elderly patients with confirmed LABC underwent TE-neoadjuvant chemotherapy with hollow needle biopsy, including 17 cases of stage Ⅲa, 11 cases of stage Ⅲb and 2 cases of stage Ⅲc The median age was 74 years. The dose of chemotherapy was docetaxel 75mg / m2, d1 intravenous infusion, epirubicin 60mg / m2, d1 intravenous infusion every 3 weeks for 1 cycle. After 2 cycles of TE regimen, Assessment, to decide whether to give 1 to 2 cycles of TE before surgery or radiotherapy. [Results] Thirty patients underwent neoadjuvant chemotherapy for 2 to 4 cycles of TE and 25 patients reduced the clinical stage (75.0%, 25/30). The clinical complete response rate (CCR) and clinical partial response rate (CPR) were 23.3% (7/30) and 53.3% (16/30), respectively. Surgical resection rate was 96.7% (29/30). Common side effects include: neutropenia, mild to moderate hair loss, nausea, vomiting, fluid retention, muscle and joint pain. Grade III and IV neutropenia were 23.3% (7/30) and 3.3% (1/30), respectively. [Conclusion] TE regimen neoadjuvant chemotherapy is safe and effective in the treatment of elderly patients with LABC, which can reduce the clinical stage and improve the postoperative quality of life.