摘要
目的:探讨高危乳腺癌术后以吡柔比星(THP)为主密集化疗的临床疗效。方法:选取2004年1月～2005年12月收治高危因素乳腺癌81例,随机分为密集化疗和常规化疗。两组患者化疗药物剂量THP 60mg/m^2 d1,紫杉醇(PTX)175mg/m^2 d2。密集化疗组每14d重复,常规化疗组每21d重复,共化疗4个周期。结果:全部患者均按计划完成治疗,随访5年,随访率95.06%。密集化疗组3年总生存率92.68%,常规化疗组3年总生存率75.00%,两组比较差异有统计学意义(χ~2=4.70,P<0.05);两组3年无瘤生存率两组分别是87.80%和67.50%,比较差异有统计学意义(χ~2=4.83,P<0.05);两组5年总生存率分别为60.97%和35.00%;两组比较差异有统计学意义(χ~2=5.47,P<0.05);两组5年无瘤生存率分别为53.65%和27.50%。两组比较差异有统计学意义(χ~2=5.74,P<0.05)。密集化疗组中Ⅰ～Ⅱ度和Ⅲ～Ⅳ度白细胞降低分别为70,73%和21.94%,Ⅰ～Ⅱ度血小板减少为31.71%,无Ⅲ～Ⅳ度血小板减少。而常规化疗组Ⅰ～Ⅱ度和Ⅲ～Ⅳ度白细胞降低分别为54.20%和25.00%,Ⅰ～Ⅱ度血小板减少为12.50%,无Ⅲ～Ⅳ度血小板减少。两组患者均未出现粒缺性发热。结论:密集化疗能有效延长高危乳腺癌患者的生存期,不良反应可耐受。
Objective： To observe the clinical effect of dose-dense chemotherapy with THP-containing agents in the postoperative treatment for high risk breast cancer. Methods： During a period from January 2004 to December 2005, 81 patients with high risk breast cancer were randomly allocated into two groups： the Doseense Group （G1） and the Conventional Chemotherapy Group （G2）. The dose of the chemotherapeutic agents was THP60mg/m2 dl and PTX175mg/m2 d2. The administration was repeated every 14 days in the G1 group and every 21 days in the G2 group, with a total treatment of 4 cycles. Results： There were 41 patients in the G1 group and 40 patients in the G2 group. All 81 patients completed chemotherapy as planned. All patients were followed-up for more than 5 years, with a follow-up rate of 95.06%. The 3-year overall survival rate was 92.68% and 75.0% （x^2 = 4.70, P〈 0.05 ） in G1 and G2, respectively. The 3-year relapse-free rate was 87.80% and 67.50% in the two groups （x^2 = 4.83, P〈 0.05 ）, with significant differences between the two groups. The 5-year overall survival rate was 60.97% and 35.00% （x^2= 5.47, P〈 0.05 ） in G1 and G2, and the 5-year tumor-free survival was 53.65% and 27.5%% （x^2= 5.74, P 〈 0.05 ） in G1 and G2, respectively, with significant differences between the two groups. The major toxicities included neutropenia, nausea, vomiting, hepatic lesions and alopecia. The incidence of grade Ⅰ - Ⅱ and grade Ⅲ-Ⅳ neutropenia were 70.73% and 21.94% in G 1, respectively, and the incidence of grade Ⅰ - Ⅱ and grade Ⅲ-Ⅳ thrombopenia were 31.71% and 0 in G1, respectively. The incidence of grade Ⅰ - Ⅱ and grade Ⅲ-Ⅳ neutropenia were 54.20% and 25.00% in G2, respectively, and the incidence of grade Ⅰ - Ⅱ and grade Ⅲ-Ⅳ thrombopenia were 12.50% and 0 in G2, respectively. The median DFS and OS were not obtained. Agranulocytic fever was not observed in any patients. Conclusion： Postoperative dose-dense chemotherapy for high risk breast cancer can effectively improve the 3- and 5-year survival rates and the adverse side effects are tolerable.
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2011年第3期151-154,共4页
Chinese Journal of Clinical Oncology
基金
国家自然科学基金资助(编号:30424005)~~
