保乳手术联合新辅助化疗治疗乳腺癌的安全性分析

【摘要】 目的探讨保乳手术联合新辅助化疗治疗乳腺癌的安全性。方法选取2005年3月~2008年3月广州市海珠区妇幼保健医院收治的乳腺癌患者148例,按照患者意愿分为观察组(n=89)和对照组(n=59)。对照组行乳腺癌改良根治术,观察组先给予以紫杉醇和(或)表阿霉素为主的联合新辅助化疗,化疗效果达到完全缓解(CR)或部分缓解(PR),且原发病灶缩小至≤3 cm者行保乳手术,否则行乳腺癌改良根治术。对两组患者术后5年局部复发率、生存率及手术后并发症、外观效果进行比较。结果 (1)观察组所有患者均完成预期的化疗周期,临床缓解率(PR+CR)为78.7%(70/89),成功完成保乳手术61例;(2)观察组行保乳手术患者术后并发症率显著少于对照组,差异有统计学意义(χ2=5.908,P<0.05),乳房外观效果优良率为78.69%(48/61)。两组术后5年局部复发率比较(χ2=3.348)及生存率比较(χ2=0.774),差异无统计学意义。结论保乳手术并不会显著增加复发风险,而新辅助化疗为更多的患者提供了保乳条件。新辅助化疗联合保乳手术具有较高的安全性,而且提高了患者术后生活质量。更多还原

【Abstract】 Objective To investigate the feasibility of Breast-conserving surgery(BCS) for breast carcinoma after neoadjuvant chemotherapy. Method A total of 148 patients with breast carcinoma in the hospital from Mar.2003 to Sep.2008 were allocated into observation group(89 cases) and control group(59 cases) according to the wishes of patients. Control group underwent mastectomy, and observation group were given Taxol and(or) epirubicin-based neoadjuvant chemotherapy fi rst. When the effect of chemotherapy achieved Complete Response(CR)or Partial Response(PR),and the primary lesion reduced to≤3 cm,the patients underwent BCS, Otherwise the patients underwent mastectomy.Then the 5-year local recurrence rate,surrival rate,post-operative complications and appearance of the two groups were compared. Results(1)All patients of the observation group completed the expected cycle of chemotherapy, Clinical remission rate(PR + CR) was 78.7%(70/89),61 cases underwent BCS fi nally.(2) The postoperative complication rate of the observation group was signifi cantly less than the control group(χ2=5.908,P<0.05),Breast appearance excellent rate 78.69%(48/61). Two groups 5-year local recurrence rate(χ2=3.348,P>0.05) and survival rate(χ2=0.774,P>0.05) showed no signifi cant difference. Conclusion BCS does not signifi cantly increase the risk of recurrence, and neoadjuvant chemotherapy serve more patients with breast-conserving conditions.Neoadjuvant chemotherapy combined with BCS has high security, but also improve the quality of life of patients.更多还原