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目的探讨动脉内灌注新辅助化疗对晚期乳腺癌疗效及病理特征的影响。方法36例晚期乳腺癌术前超选择动脉置泵灌注化疗。化疗方案为CEF方案:5氟尿嘧啶(5Fu)500mg/m2,环磷酰胺(CTX)400mg/m2,表阿霉素(EPI)60mg/m2。每周1～2次,2～3次为一个疗程,休息2周后可重复灌注化疗,2～3个疗程后进行手术。结果动脉内灌注新辅助化疗后,术前肿瘤病灶临床完全缓解(CR)6例。部分缓解(PR)25例,稳定(MR)5例,有效率(CR+PR)86.1%。术后病理学检查发现:癌细胞均有不同程度的核固缩,碎裂,胞浆凝固,变性;细胞间质水肿,纤维增生,炎细胞浸润;血管内膜增厚,血栓形成。结论动脉内灌注新辅助化疗可以明显改变晚期乳腺癌的组织学形态,改善临床症状,提高生存率。
Objective To investigate the effect of intra-arterial neoadjuvant chemotherapy on the efficacy and pathological features of advanced breast cancer. Methods 36 cases of advanced breast cancer preoperative superselective arterial pump infusion chemotherapy. The chemotherapy regimen was CEF regimen: 500 ug / m2 of 5 fluorouracil, 400 mg / m2 of cyclophosphamide (CTX) and 60 mg / m2 of epirubicin (EPI). 1 to 2 times a week, 2 to 3 times for a course of treatment, rest 2 weeks after repeated infusion chemotherapy, 2 to 3 courses after surgery. Results Intra-arterial neoadjuvant chemotherapy preoperatively showed 6 cases of complete remission (CR) of tumor lesions. 25 cases were partial response (PR), 5 cases were stable (MR), and the effective rate was (CR + PR) 86.1%. Postoperative pathological examination found: cancer cells have varying degrees of nuclear pyknosis, fragmentation, cytoplasmic coagulation, degeneration; interstitial edema, fibrosis, inflammatory cell infiltration; intimal thickening, thrombosis. Conclusion Intra-arterial neoadjuvant chemotherapy can significantly change the histological morphology of advanced breast cancer, improve clinical symptoms and improve survival rate.