目的:对比观察FEC序贯(氟尿嘧啶+表柔比星+环磷酰胺)T方案(多西他赛)同步放疗与序贯放疗的近期疗效及不良反应,评估同步放化疗治疗模式的可行性。方法:2009-01-01-2011-05-31广西医科大学第四附属医院肿瘤科71例T3和T4期且淋巴阳性或N2和N3期乳腺浸润性导管癌改良根治术后患者,给予FEC序贯T方案辅助化疗,采用密闭信封法随机分为同步治疗组(37例,多西他赛化疗阶段同步辅助放射治疗)和序贯治疗组(34例,完成辅助化疗后序贯辅助放射治疗)。观察两组近期疗效及不良反应。结果:71例患者均完成所有周期化疗及放射治疗。同步治疗组均于术后10~13周内开始放射治疗,放化疗全程治疗时间为18~21周,平均18.3周。序贯治疗组均于术后19~24周开始放射治疗,放化疗全程治疗时间为21~26周,平均23.7周。两组对比,同步治疗组放疗开始的时间平均缩短了9.6周,辅助放化疗时间平均缩短了5.4周。随访至2013-12-30,随访时间13~39个月,中位随访时间25个月。局部复发率同步治疗组为2.7%(1/37),序贯治疗组为5.9%(2/34),P=0.468。远处转移率同步治疗组为8.1%(3/37),序贯治疗组为14.7%(5/34),P=0.308。2年无局部复发生存同步治疗组为97.3%(36/37),序贯治疗组为94.1%(32/34),P=0.468;2年无疾病进展生存同步治疗组为89.2%(33/37),序贯治疗组为79.4%(27/34),P=0.210。两组患者治疗期间肝肾功能损害发生率均较低,均无药物相关或放射性心肺损伤病例,主要不良反应为骨髓抑制、胃肠道反应及射性皮肤反应。结论:局部晚期乳腺癌患者术后同步放化疗缩短了治疗时间,耐受性良好,有改善疗效的趋势,安全可行,值得进一步观察。 OBJECTIVE: To compare the short-term efficacy and side effects of sequential radiotherapy (Fluorouracil + epirubicin + cyclophosphamide) T regimen (docetaxel) with sequential radiotherapy and sequential radiotherapy to evaluate the feasibility of concurrent radiotherapy and chemotherapy. Method: 2009-01-01-2011-05-31 Department of Oncology, the Fourth Affiliated Hospital of Guangxi Medical University 71 cases of T3 and T4 and lymph node positive or N2 and N3 breast invasive ductal carcinoma patients after modified radical grafts were given FEC sequence T-adjunct chemotherapy, sealed capsule method were randomly divided into synchronous treatment group (37 cases, docetaxel chemotherapy stage of synchronous adjuvant radiotherapy) and sequential treatment group (34 cases, complete adjuvant chemotherapy after adjuvant radiotherapy) . The two groups were observed the short-term efficacy and adverse reactions. Results: All 71 patients completed all cycles of chemotherapy and radiotherapy. The patients in the concurrent treatment group started radiotherapy within 10 to 13 weeks after operation, and the full course of radiotherapy and chemotherapy was 18 to 21 weeks with an average of 18.3 weeks. The sequential treatment group started radiotherapy 19 to 24 weeks postoperatively, and the whole course of radiotherapy and chemotherapy was 21 to 26 weeks, with an average of 23.7 weeks. Comparing the two groups, the time to start radiotherapy in the synchronized treatment group was shortened by an average of 9.6 weeks, and the adjuvant radiotherapy and chemotherapy time was reduced by an average of 5.4 weeks. Follow-up to 2013-12-30, follow-up time of 13 to 39 months, the median follow-up time of 25 months. The local recurrence rate was 2.7% (1/37) in the concurrent treatment group and 5.9% (2/34) in the sequential treatment group, P = 0.468. The rate of distant metastasis was 8.1% (3/37) in the concurrent treatment group and 14.7% (5/34) in the sequential treatment group, P = .308. 97.3% (36/37) in 2 years without local recurrence, , Sequential therapy group was 94.1% (32/34), P = 0.468; 89.2% (33/37) in the two-year progression-free survival group and 79.4% (27/34) in the sequential therapy group, P = 0.210. The incidence of liver and kidney dysfunction was lower in both groups during the treatment. No drug-related or radiation-induced cardiopulmonary injury was found. The main adverse reactions were myelosuppression, gastrointestinal reaction and radioactive skin reaction. CONCLUSION: The concurrent chemoradiotherapy after operation in patients with locally advanced breast cancer shortens the treatment time and is well tolerated. It has the tendency of improving efficacy and is safe and feasible. It is worth further observation.