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目的比较两组不同周期的新辅助化疗对乳腺癌疗效的影响及毒性反应。方法 75例局部进展期乳腺癌患者接受表阿霉素和紫杉醇 (epirubicinandpaclitataxel,ET)方案进行新辅助化疗 (neo adjuvantchemotherapy ,NAC)。其中有 39例完成 2个周期治疗 ,36例完成 4个周期治疗 ,对两组的疗效进行比较分析。结果NAC 2周期组的总有效率为 74 % (2 9/ 39) ,其中临床完全缓解(cCR) 1例 ,部分缓解 (PR) 2 8例 ,无变化 (NC) 10例 ;4周期组的总有效率 94 % (34/ 36 ) ,cCR 2 1例 ,PR 13例 ,NC 2例 ,其中包括病理完全缓解 (pCR) 9例 ,两组均无进展病例。 2周期组有 18例 (4 6 % )、4周期组为 2 7例 (75 % )肿大淋巴结消失。两组间毒性反应比较 ,在关节肌肉疼痛及神经毒性方面 ,4周期治疗组重于 2周期组。结论ET方案对局部进展期乳腺癌进行新辅助化疗 ,在肿瘤及淋巴结缩小 (降期 )效果方面 ,4周期组明显优于 2周期组。在毒性反应方面 ,除关节肌肉疼痛及神经毒性症状 4周期治疗组稍重于 2周期组外 ,在血液毒性及消化道反应方面两组差异无显著性。
Objective To compare the effects of neoadjuvant chemotherapy with different cycles on the curative effect and toxicity of breast cancer in two groups. Methods 75 patients with locally advanced breast cancer received epirubicin andpaclitataxel (ET) regimen for neoadjuvant chemotherapy (NAC). Among them, 39 cases completed 2 cycles of treatment, 36 cases completed 4 cycles of treatment, the efficacy of the two groups were compared. Results The total effective rate of NAC 2 cycles group was 74% (29/39), including 1 case of complete clinical remission (CCR), 28 cases of partial remission (PR) and 10 cases of no change (NC) The total effective rate was 94% (34/36). There were 1 case of cCR 2, 13 cases of PR and 2 cases of NC, including 9 cases of complete remission (pCR). No progress was found in both groups. Eighteen patients (46%) in the 2-week group and 27 (75%) in the 4-week group disappeared. Toxicity was compared between the two groups in terms of joint muscle pain and neurotoxicity, 4-week treatment group was heavier than the 2-week group. Conclusions The ET regimen is a neoadjuvant chemotherapy for locally advanced breast cancer. Compared with the 2-week group, the 4-cycle group is significantly more effective in reducing the tumor and lymph nodes. In terms of toxicity, there was no significant difference in hematologic toxicity and gastrointestinal tract between the two groups except for the 4-week treatment group with symptoms of joint muscle pain and neurotoxicity.