【摘要】 目的探讨以蒽环类药物吡柔比星(THP)为主的联合新辅助化疗对III期原发性乳腺癌新辅助化疗的近期临床效果。方法对1 3 8例手术前确诊的III期原发性乳腺癌采用以吡柔比星为主的CTF方案化疗1~4个周期,观察临床疗效、保乳手术率和毒副反应。结果全组总有效率为7 5.4%(1 0 4/1 3 8);其中完全病理缓解1例,临床完全缓解1例(0.7%),部分缓解1 0 2例(73.9%),无变化3 2例(2 3.2%),进展2例(1.4%)。实施保乳手术7例(5.1%)。施行化疗3+4周期的疗效和保乳手术率均明显高于1+2周期者(均P<0.0 5)。该方案的脱发反应轻,I度脱发2 8例(2 0.3%);心脏毒性较小,室性期外收缩发生率1.4%(2/1 3 8),无充血性心衰病例。但骨髓抑制较明显,总发生率5 5.8%(7 7/1 3 8),其中II度骨髓抑制发生率为2 7.5%(3 8/1 3 8),III度骨髓抑制发生率为2 1.0%(2 9/1 3 8),IV度骨髓抑制发生率为7.2%(1 0/1 3 8)。结论以吡柔比星为主的CTF方案用于乳腺癌新辅助化疗心脏毒性小,近期疗效较满意;但骨髓抑制发生率高,治疗期间应予支持治疗。更多还原

【Abstract】 Objective To investigate the short-term effect of anthracycline(pirarubicin)-based combination regimen as neoadjuvant chemotherapy for stage III primary breast cancer.Methods For 138 patients with stage III primary breast cancer, one to four cycles of anthracycline-based combination chemotherapy as CTF regimen were given.The clinical results,the feasibility rate of conservative breast surgery and toxic and side reaction were observed.Results The overall response rate was 75.4%(104/138),including one case with clinical complete response(cCR),and 102 cases with clinial partial response(cPR),no change rate 23.2%,and progressive disease rate(PD) 1.4%(2/138).Seven cases received conservative breast(surgery)(5.1%,7/138).The cardiotoxicity was light without congestive heart failure,and the incidence of premature ventricular extrasystole(PVE) was 1.4%.The regimen resulted in mild alopecia and serious(myelosuppression).The incidence of grade II myelosuppression was 27.5%,grade III 21.0%, and grade IV 7.2%.Conclusions the short-term effect of anthracycline-based combination neoadjuvant chemotherapy as CTF regimen for primary breast cancer was satisfactory with little cardiotoxic effects.更多还原