摘要
目的分析不同评价方法评估乳腺癌新辅助化疗疗效的价值,探讨化疗疗效的影响因素。方法对171例Ⅱ、Ⅲ期可手术乳腺癌患者分别行CEF、NE和TEC方案新辅助化疗。完成2个周期化疗者11例,3个周期者111例,≥4个周期者49例。采用触诊、超声和病理学方法评价疗效。化疗效果影响因素的判定采用单因素分析和多因素Logistic回归分析方法。结果触诊评价完全缓解(CR)32例(18．7%),总有效率为88．3%。超声评价CR 7例(4．1%),总有效率为74．9%。病理组织学评价CR 26例(15．2%)。触诊和超声评价与病理组织学评价的CR符合率分别为43．8%和42．9%。多因素分析结果表明,肿瘤大小是影响乳腺癌新辅助化疗病理CR的独立因素。结论化疗疗效的临床评价与病理组织学评价缺乏很好的一致性,触诊和超声评价CR易高估和低估。肿瘤大小是影响乳腺癌新辅助化疗病理CR的独立因素,肿块小易达到病理CR。
Objective To assess the response of neoadjuvant chemotherapy and its influencing factors in the breast cancer patients. Methods 171 patients with stage Ⅱ or operable stage Ⅲ breast cancers were treated with neoadjuvant chemotherapy before surgery between January 2004 and May 2005. Of these, 160 received and completed ≥3 cycles of neoadjuvant chemotherapy, 11 received only 2 cycles. The regimens of neoadjuvant chemotherapy were： CEF（ CTX, Epirubicin, 5-Fu） ; NE（ Navelbine, Epirubicin） ; TEC（ Taxotere, gpirubicin, CTX）. Response of neoadjuvant chemotherapy was evaluated in all patients by palpation, uhrasonography and pathological methods. Results Complete response rate and clinical objective response rate determined by clinical palpation （ cCR, cOR）, uhrasonography （ sCR, sOR） and pathology （pCR） was 18.7% and 88.3% ; 4.1% and 74.9% ; 15.2% , respectively. The correspondence rate of the pCR with cCR and sCR was 43.8% and 42.9%, respectively. It was showed by univariate analysis that patient whose tumor was ≤3 cm in diameter, or ER negative or grade 3 were more likely to achieve a pCR than those whose tumor was 〉 3 cm, or ER positive or grade 1. Logistic regression analysis showed that only tumor size was the significant predictive factor for response to neoadjuvant chemotherapy in patients with primary breast cancer. Conclusion Patient with small, or ER negative or grade 3 tumor may have better pathological response to neoadjuvant chemotherapy, particularly, the tumor size is more predictive of pCR. Palpation or uhrasonography may have a tendency either to under- or to overestimate pCR.
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2006年第11期867-870,共4页
Chinese Journal of Oncology
