【摘要】 目的:探讨新辅助化疗分别在Ⅱ期和Ⅲ期乳腺癌中的应用价值。方法:选取1994年9月～1999年9月术前经病理确诊可手术乳腺癌426例,分为新辅助化疗组(A组)和对照组(B组)。分析两组的术式选择、局部控制和5年生存率,评价新辅助化疗在Ⅱ、Ⅲ期乳腺癌治疗中的价值。结果:Ⅱ期可保乳率由24.7%提高到44.6%(P=0.000),两组5年总生存率(OS)和无瘤生存率(DFS)无差异(P=0.525、0.581)。Ⅲ期A组患者5年OS和DFS(62.9%、58.1%)均高于B组(39.5%、32.6%)(P=0.014、0.010)。Ⅱ、Ⅲ期化疗后需植皮术均下降(P=0.000、0.000),3年内复发转移A组均低于B组(P=0.035、0.027)。结论:新辅助化疗可提高Ⅱ、Ⅲ期可手术乳腺癌患者的保乳率、减少植皮术、降低局部复发转移;可提高Ⅲ期乳腺癌患者的5年生存率。更多还原

【Abstract】 Objective:To evaluate the therapeutic value of neoadjuvant chemotherapy for patients with stage Ⅱ and Ⅲ breast cancer.Methods:A total of 26 breast cancers patients at stage Ⅱ and Ⅲ,pathologically proven during September 1994 to September 1999,were studied,which were divided into neoadjuvant chemotherapy group(A)and control group(B).The impact of neoadjuvant chemotherapy on surgical methods choice,local control rate,5-year overall survival rate(OS)and 5-year disease-free survival rate(DFS)were analyzed and the therapeutic value of neoadjuvant chemotherapy on the breast cancer patients at stage Ⅱ and Ⅲ were discussed.Results:For patients of stage Ⅱ,the rate of breast conservation significantly increased from 24.7% to 44.6%(P=0.000)and there was no significant difference between group A and B(P=0.525,0.581)in 5-year OS and DFS.For patients of stage Ⅲ,the 5-year OS(62.9%)and DFS(58.1%)in group A were greatly higher than that in group B(39.5% and 32.6%)(P=0.014,0.010).The imperative dermatoplasty rate of the breast cancer patients at stage Ⅱ and Ⅲ in Group A decrease greatly(P=0.000?0.000)and the 3-year local relapse and metastasis rate were lower than group B(P=0.035?0.027).Conclusion:The neoadjuvant chemotherapy can improve potential rate of breast conservation,reduce the rate of imperative dermatoplasty,local-regional recurrence rate and distant metastasis for the patients with stage Ⅱ and Ⅲ breast cancer,and can also improve the 5-year survival rate for the patients of stage Ⅲ更多还原