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目的评价NEF方案用于可手术乳腺癌新辅助化疗的近期疗效及其不良反应。方法2000至2004年应用NEF方案治疗Ⅱb~Ⅲ期可手术乳腺癌患者52例。NEF方案:长春瑞滨(NVB)30 mg/m2,d1,5;EPI 50 mg/m2,d1;5-Fu 500 mg/m2,d1~5。28 d为1个周期,所有患者完成2个周期新辅助化疗后评价疗效,化疗结束后2~3周手术。结果34例(65.4%)降低了临床分期;其中完全缓解(CR)3例(5.8%),病理完全缓解(pCR)2例(3.8%),部分缓解(PR)35例(67.3%),病变稳定(SD)14例(26.9%),全组无疾病进展(PD)者,总有效率(CR+PR)为73.1%。Ⅱb期、Ⅲa期、Ⅲb期有效率分别为83.3%(15/18)、69.6%(16/23)和63.6%(7/11),Ⅱb期有效率高于Ⅲa期和Ⅲb期。新辅助化疗2个周期后有42.0%(21/50)未触及肿大淋巴结;46.0%(23/50)肿大淋巴结明显缩小,腋窝淋巴结总有效率为88.0%(44/50)。毒副反应为白细胞下降、恶心呕吐、脱发、神经毒性和周围静脉炎等,患者均可耐受。结论NEF方案用于可手术乳腺癌新辅助化疗,对原发灶和腋窝淋巴结均有较高的有效率,而且可以降低临床分期,不良反应可耐受,值得推广。
Objective To evaluate the short-term efficacy and adverse reactions of NEF regimen in neoadjuvant chemotherapy for operable breast cancer. Methods From 2000 to 2004, 52 patients with operable stage Ⅱb-Ⅲ breast cancer were treated with NEF regimen. NEF regimen: vinorelbine (NVB) 30 mg / m2, d1,5; EPI 50 mg / m2, d1; 5-Fu 500 mg / m2, d1-5.28 d for 1 cycle, all patients completed 2 Evaluation of the efficacy of neoadjuvant chemotherapy cycle, 2 to 3 weeks after the end of chemotherapy surgery. RESULTS: Thirty-four patients (65.4%) reduced the clinical stage. Three patients (5.8%) had complete remission (CR), two patients had complete remission (pCR) Fourteen patients (26.9%) with stable disease (SD) and 73.1% patients with no disease progression (PD) had a total effective rate (CR + PR). The effective rates of stage Ⅱb, Ⅲa and Ⅲb were 83.3% (15/18), 69.6% (16/23) and 63.6% (7/11), respectively. The effective rates of stage Ⅱb were higher than those of stage Ⅲa and Ⅲb. After two cycles of neoadjuvant chemotherapy, 42.0% (21/50) did not touch the enlarged lymph nodes; 46.0% (23/50) enlarged lymph nodes were significantly reduced, the total effective rate of axillary lymph nodes was 88.0% (44/50). Side effects of leukopenia, nausea and vomiting, hair loss, neurotoxicity and peripheral phlebitis, patients can tolerate. Conclusion The NEF regimen is suitable for neoadjuvant chemotherapy of operable breast cancer. It has high efficiency in primary tumor and axillary lymph node, and can reduce clinical staging and adverse reactions. It is worth to be promoted.