摘要
目的探讨新辅助化疗用于局部进展期乳腺癌的临床价值。方法选取1996年1月至2006年12月经病理确诊的局部进展期乳腺癌522例,随机分为新辅助化疗组264例和对照组258例。新辅助化疗组给予FEC或TEC方案化疗4～6周期后进行手术,符合保乳条件者实施保乳手术;对照组实施全乳房切除术。分析新辅助化疗对局部进展期乳腺癌保乳率以及预后的影响。结果新辅助化疗组总有效率为89.19%(231/259),82.20%(217/264)的患者达到保乳条件,其中实际实施保乳手术85例。经67.4(36～166)个月随访,新辅助化疗组的复发率、转移率、总生存率及无病生存率与对照组相比,差异均无统计学意义(P>0.05);临床完全缓解者的总生存率和无病生存率分别为92.64%(63/68)、88.23%(60/68),高于未达到临床完全缓解者的81.15%(155/191)、73.82%(141/191),差异有统计学意义(P=0.026;P=0.017);病理完全缓解的35例患者OS、DFS分别为97.14%(34/35)、94.19%(33/35),未达到病理完全缓解的224例患者OS、DFS分别为81.25%(182/224)、75%(168/224),差异均有统计学意义(P=0.019;P=0.015)。结论新辅助化疗可以使局部进展期乳腺癌的原发肿瘤缩小,提高保乳率,准确地进行治疗前分期将是判断新辅助化疗对该癌预后影响的关键。
Objective To investigate the effects of neoadjuvant chemotherapy（NAC）for locally advanced breast cancer（LABC）.MethodsA total of 522 patients with LABC collected from January 1996 to December 2006 were enrolled and assigned randomly into NAC（T）group and control（C）group.Breast-conserving surgery（BCS）and total mastectomy（MT）were performed selectively for T group,after 4-6 cycles of NAC treatment that consist of FEC（5-Fluorouracil,Epirubicin,Cyclophosphamide）or TEC（Docetaxel,Epirubicin,Cyclophosphamide）.MT was used only for C group.The rate of BCS and prognosis of LABC after NAC were analyzed.Results The response rate in T group was 89.19%（231/259）,82.20%（217/264）of the patients became eligible for BCS after NAC among which 85 patients underwent BCS.After following-up for 36-166（median 67.4）months,there showed no significant difference between the patients in T and C group on the rates of recurrence,metastasis,overall survival and disease-free survival.The rates of overall survival and disease-free survival for complete clinical responders were 92.64%（63/68）and 88.23%（60/68）respectively,for incomplete clinical responders were 81.15%（155/191）and 73.82%（141/191）respectively,and differences were significant（P=0.026;P=0.017）.Similarly,the rates of overall survival and disease-free survival in the pathological complete response（PCR）group were 97.14%（34/35）and 94.19%（33/35）respectively,while in the group that did not achieve PCR were 81.25%（182/224）and 75%（168/224）respectively,the differences between the two groups were significant（P=0.019;P=0.015）.ConclusionsNeoadjuvant chemotherapy for patients with LABC can reduce the tumor size,improve the rate of breast conservation.To precisely assess the stage before treatment is crucial for judging the effects of NAC on prognosis of LABC.
出处
《中国癌症防治杂志》
CAS
2010年第2期85-88,共4页
CHINESE JOURNAL OF ONCOLOGY PREVENTION AND TREATMENT
基金
浙江省科技厅钱江人才计划项目(2008R10033)
浙江省医药卫生科学研究基金资助项目(2007A185)
关键词
乳腺癌
新辅助化疗
外科保乳治疗
预后
Breast cancer
Neoadjuvant chemotherapy
Surgery
Breast-conserving therapy
Prognosis
