论文部分内容阅读
目的评价大剂量表柔比星(EPI)CEF方案[环磷酰胺(CTX)+EPI+5-氟尿嘧啶(5-Fu)方案]在乳腺癌辅助化疗中的毒副反应和耐受性。方法将98例Ⅰ～Ⅲa期原发性乳腺癌患者随机分为大剂量EPI化疗组(CEF-100组)和常规剂量EPI化疗组(CEF-60组),CEF-100组和CEF- 60组分别给予:EPI 100和60 mg/m2,行CEF方案术后辅助化疗。21 d为1个周期,共6个周期。化疗期间给予相应的骨髓支持、保肝和止吐治疗。结果化疗各周期中,CEF-100组与CEF-60组白细胞数和中性粒细胞绝对值差异无统计学意义(均P>0.05),但CEF-100组由于白细胞减少引起的发热发生率高于CEF-60组(P<0.05)。CEF-100组比CEF-60组消化道毒副反应(恶心呕吐、口腔炎)和肝功能异常的发生率高,程度重(均P<0.05),但经对症处理均可缓解。两组均未出现严重的髓外毒副反应及心脏毒性,均未发生治疗相关死亡。结论原发性乳腺癌患者对大剂量EPI CEF方案治疗耐受性良好,远期疗效尚有待进一步随访观察。
Objective To evaluate the toxicity and tolerability of the high-dose epirubicin (EPI) CEF regimen [cyclophosphamide (CTX) + EPI + 5-fluorouracil (5-Fu) regimen] in adjuvant chemotherapy for breast cancer. Methods A total of 98 patients with stage Ⅰ ~ Ⅲa primary breast cancer were randomly divided into high-dose EPI chemotherapy group (CEF-100 group) and conventional EPI chemotherapy group (CEF-60 group), CEF-100 group and CEF-60 group Were given: EPI 100 and 60 mg / m2, line CEF regimen postoperative adjuvant chemotherapy. 21 d for a period of 6 cycles. The corresponding bone marrow support during chemotherapy, liver protection and antiemetic treatment. Results There were no significant differences in leucocyte count and neutrophil absolute value between CEF-100 group and CEF-60 group during chemotherapy (all P> 0.05), but the incidence of fever due to leukopenia in CEF-100 group was high In CEF-60 group (P <0.05). CEF-100 group than the CEF-60 group of gastrointestinal toxicity (nausea and vomiting, stomatitis) and liver dysfunction, high degree of severity (all P <0.05), but can be alleviated by symptomatic treatment. No serious extramedullary toxicity and cardiotoxicity occurred in either group, and no treatment-related death occurred. Conclusion The patients with primary breast cancer are well tolerated by high-dose EPI CEF and the long-term therapeutic effect remains to be further investigated.