【摘要】 目的:研究表柔比星加紫杉醇新辅助化疗方案治疗乳腺癌的近期疗效及毒副反应。方法:用TE方案(紫杉醇加表柔比星)对Ⅱ、Ⅲ期的20例乳腺癌进行新辅助化疗,3-4周为1个周期,患者完成2-4个周期后评价疗效;并以VE方案(长春瑞滨加表柔比星)作对照组进行比较,TE方案:表柔比星(EPI)60 mg/m2,第1天,静脉注射;紫杉醇(TAX)150mg/m2,第2天,静脉点滴;3周为1个周期。VE方案:EPI 60mg/m2,第1天,静脉注射;长春瑞滨(VNR)30mg/m2,第1、8天,静脉注射;4周为1个周期。结果:TE组有效率为80％,其中临床完全缓解(cCR)3例,部分缓解(PR)13例,无变化(NC)4例,病理完全缓解(pCR)2例;VE组有效率为80％,其中cCR 3例,PR 13例,NC 4例,pCR2例。两组均无进展(PD)者。进行4周期新辅助化疗患者有效率高于2周期患者。两组白细胞下降、胃肠道反应、面色潮红和静脉炎等毒副反应相似,VE组乏力、脱发、神经毒性程度比TE组显著(P<0.05),而在关节头痛方面TE组显著(P<0.05)。结论:两组新辅助化疗方案治疗乳腺癌近期有效率较高,疗效相当;VE组毒副反应较TE组高,但均可耐受。更多还原

【Abstract】 Purpose: To study the short-term efficacy and toxicity of the neoajuvant chemotherapy with epirubicin (EPI) plus paclitaxel( TAX) in treatment of patients with breast cancer. Methods: 20 patients with stage Ⅱ,Ⅲ breast cancer were treated with paclitaxel plus epirubicin (TE) for 2 - 4 cycles every 3 weeks, their clinical response and the toxicity were assessed after 2-4 cycles of neoajuvant chemotherapy, and they are compared with those of the patients treated with vinorelbine plus epirubicin( VE) as neoadjuvant chemotherapy. Patients in TE arm received epirubicin 60 mg/m2 by intravenous injection on d 1, paclitaxel 150 mg/m2 by 3-hour continuous infusion on d 2, 3 weeks was 1 cycle. Patients assigned to the VE arm received epirubicin 60 mg/m2 by intravenous injection on d 1, vinorelbine 30 mg/m by intravenous injection on d 1 and d 8, 4 weeks was 1 cycle. All patients were treated by modified radical operation after neoajuvant chemotherapy. Results: The overall response rate( RR) was 80% (16/20) both in TE arm and VE arm. There were 3(15%) clinical complete response( cCR) and 2(10%) pathologic complete response ( pCR) in every arm. No patient showed progressive disease. A higher proportion of RR and pCR was observed in patients with 4 cycles of neoajuvant chemotherapy than those with 2 cycles in the two groups. The major toxicity, including leukopenia, gastroenteric reaction, flushing of face and phlebitis, were similar in both groups, but fatigue, alopecia and neurotoxicity were more severe in VE arm than in TE arm(P<0.05), myalgia and cephalalgia were more severe in the TE arm than in VE arm(P <0. 05). Conclusions: The two different regimens used as neoajuvant chemotherapy for breast cancer were both effective and their results were similar. The side effects in VE was higher than that in TE, but were all tolerable.更多还原