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目的:探讨不同方案新辅助化疗后行保乳手术治疗三阴性乳腺癌的临床疗效及安全性。方法:收集2006年1月至2015年6月于我院确诊的可手术三阴性乳腺癌患者90例作为研究对象,按照随机数字表法分为观察组及对照组各45例。观察组患者在保乳手术前给予AC-T方案进行新辅助化疗,对照组患者在保乳手术前给予TAC方案进行新辅助化疗。观察并比较两组患者治疗效果、化疗相关不良反应发生情况、术后并发症发生情况以及生活质量的改善情况。结果:观察组总有效率为82.22%,对照组为73.33%;观察组控制率为95.56%,对照组为91.11%,两组总有效率及控制率比较差异无统计学意义(P>0.05);观察组患者中性粒细胞减少、胃肠道不良反应及口腔溃疡发生率均低于对照组(P<0.05),而两组脱发情况比较差异无统计学意义(P>0.05)。两组术后并发症发生率分别为6.67%及11.11%,组间比较差异无统计学意义(P>0.05)。观察组患者术后生活质量改善总有效率为86.67%,对照组总有效率为82.22%,两组相比差异无统计学意义(P>0.05)。结论:在保乳手术前采用AC-T序贯化疗方案进行新辅助化疗治疗三阴性乳腺癌与TAC方案疗效相当,但不良反应明显减少,值得临床推广应用。
Objective: To investigate the clinical efficacy and safety of breast-conserving surgery in patients with triple-negative breast cancer after neoadjuvant chemotherapy with different regimens. Methods: Totally 90 patients with operable triple negative breast cancer diagnosed in our hospital from January 2006 to June 2015 were enrolled in this study. According to the random number table, 45 cases were divided into observation group and control group. Patients in the observation group were given neoadjuvant chemotherapy before the operation of breast-conserving surgery, while those in the control group were given neoadjuvant chemotherapy before the operation of breast-conserving surgery. The therapeutic effect, the incidence of chemotherapy-related adverse reactions, the incidence of postoperative complications and the quality of life were observed and compared between the two groups. Results: The total effective rate was 82.22% in the observation group and 73.33% in the control group. The control rate was 95.56% in the observation group and 91.11% in the control group. There was no significant difference in the total effective rate and control rate between the two groups (P> 0.05) The incidence of neutropenia, gastrointestinal adverse reactions and oral ulcer in the observation group were lower than those in the control group (P <0.05). There was no significant difference in the hair loss between the two groups (P> 0.05). The postoperative complications in the two groups were 6.67% and 11.11%, respectively, with no significant difference between the two groups (P> 0.05). The total effective rate of postoperative quality of life in the observation group was 86.67%, while the total effective rate in the control group was 82.22%. There was no significant difference between the two groups (P> 0.05). CONCLUSION: TAC treatment with neoadjuvant chemotherapy with AC-T sequential chemotherapy before breast-conserving surgery is equivalent to TAC, but its adverse reaction is obviously reduced. It is worthy of clinical application.