进展期乳腺癌术前新辅助化疗86例
薛锋杰，代志军，王西京，薛兴欢，康华峰，刘小旭，管海涛，张淑群
【关键词】 ,乳腺肿瘤
Preoperative neoadjuvant chemotherapy for 86 patients with advanced breast cancer
【Abstract】 AIM: To evaluate the clinical significance of CEF regimen as neoadjuvant chemotherapy for advanced breast cancer. METHODS: Eightysix patients with stage Ⅱb Ⅲ breast cancer were treated with CEF regimen for 2 treatment cycles with each lasting for 28 d. According to the effect standard and toxic grading standard suggested by WHO, the efficacy and safety were evaluated. The patients received cyclophosphamide (CTX) 500 mg/m2 on day 1 and 8, epirubincin (EPI) 50 mg/m2 on day 1, and 8, and 5fluorouracil (5Fu) 500 mg/m2 on day 1 and 8. RESULTS: The cancer degraded in 35 %) patients and the overall response rate (RR) of the primary tumor was % (43/86). Four cases had complete response (CR), 37 cases partial response (PR) and no disease progressive (PD) case. For axillary lymph nodes, the
overall response rate (RR) was % (51/83). For clinically palpable axillary lymph nodes which had been found in 83 patients before treatment, % (24/83) became inpalpable. The major toxicity included leukopenia, gastroenteric reactions and alopecia. CONCLUISON: Neoadjuvant chemotherapy with CEF regimen for advanced breast cancer is effective and tolerable and therefore, is warranted for wide use.
【Keywords】 breast neoplasms; neoadjuvant chemotherapy; clinical effect
【摘要】 目的： 探讨进展期乳腺癌新辅助化疗的临床意义. 方式： 200001/200412应用CEF方案对86例ⅡbⅢ期乳腺癌患者进行新辅助化疗. 环磷酰胺(CTX) 500 mg/m2, d1, d8；表阿霉素(EPI) 50 mg/m2, d1, d8；氟尿嘧啶(5Fu) 500 mg/m2, d1, d8. 28 d为1个周期，所有患者完成2个周期新辅助化疗后评判疗效. 结果： 35例（%）降低了临床分期；4例（%）取得完全减缓（CR），37例（%）部份减缓（PR），全组无疾病进展(PD)者，总有效率（CR+PR）为%(43/86). 新辅助化疗2个周期后有24例%) 未触及肿大淋巴结，腋窝淋巴结总有效率为%(51/83). 副反映为白细胞下降、恶心呕吐和脱发等，患者都可耐受. 结论： 进展期乳腺癌新辅助化疗对原发肿瘤和腋窝淋巴结均有较好疗效，不良反映可耐受，值得推行.
【关键词】 乳腺肿瘤；新辅助化疗；临床疗效
0引言
乳腺癌是我国女性中的要紧恶性肿瘤之一，它不仅是一局限性疾病，更是一全身性疾病，其医治也由局部医治转变成以局部和系统性的综合医治. 术前化疗或称之为新辅助化疗（neoadjuvant chemotherapy），目前在乳腺癌的医治中已取得应用，专门是在局部进展期乳腺癌的应用中已取得良好的成效［1］. 自20世纪80年代开展以来，已成为乳腺癌全身医治的一个重要组成部份. 我院对进展期乳腺癌患者86例进行新辅助化疗，取得中意成效.
1对象和方式
1．1对象
200001/200412 ⅡbⅢ期乳腺癌患者86例，术前均经细胞学或粗针穿刺获组织学检查证明. 平均年龄(27～68) 岁，按TNM分期，Ⅱb期29例，Ⅲa期36例，Ⅲb期21例. 所有患者既往未行放化疗及内分泌医治，Karnofsky评分为80分以上，心、肝、肾功能无严峻损害.
进展期乳腺癌术前新辅助化疗86例
