摘要
目的观察多西紫杉醇+阿霉素+环磷酰胺(TAC)方案新辅助化疗治疗中晚期乳腺癌的疗效和毒副反应并探讨该方案后行保乳术治疗的可行性。方法对2004年2月—2009年12月我院收治的一些有强烈保乳意愿的中晚期乳腺癌患者进行3～4个疗程TAC方案治疗,疗程结束后评价疗效和毒副反应;选取24例达到保乳指征的患者行保乳术,作为保乳组,随机抽取我院同期收治的35例未作新辅助化疗而直接行乳房根治术的中晚期患者作为对照组,从乳房满意度、局部复发率、远处转移率和5年生存率比较两组的疗效。结果化疗完成后,保乳组完全缓解(CR)4例,部分缓解(PR)15例,总有效率为79.2%;毒副反应以白细胞下降、恶心和(或)呕吐以及脱发为主,对症治疗后缓解;保乳组的乳房满意度、局部复发率、远处转移率和5年生存率分别为91.7%、12.5%、8.3%、87.5%,对照组相应的数据分别为0、5.7%、20%、88.6%。结论通过TAC方案治疗后满足保乳指征的中晚期乳腺癌患者,行保乳术治疗是一种安全可行的方法。
Objective To observe the effect and toxicity of TAC regimen as a method of neoadjuvant chemotherapy （NAT） in the treatment of intermediate stage and advanced breast cancer and investigate the feasibility of breast-conserving therapy （BCT） for pa- tients who reach the BCT indications after the TAC treatment. Methods From February 2004 to December 2009, our hospital re- ceived some intermediate stage and advanced breast cancer patients who had extremely want to keep their breasts. We treated them with TAC regimen （3 -4 courses of treatment） and evaluated the effect and toxicity of TAC regimen. After that, we chose 24 pa- tients who were eligible for BCT as breast-conserving group, and another 35 patients who didn＇ t receive NAT but underwent surgery of radical mastectomy acted as control group. The two groups were compared based on the parameters of breast satisfaction rate, tumor local recurrence and distant metastasis,and 5-year survival. Results In the breast-conserving group, after NAT, 4 patients achieved complete remission （CR） and 15 patients achieved partial remission （PR） with an overall response rate of 79.2%. The most common side effects in the breast-conserving group included leucopenia, alopeeia, nausea and vomiting, which were all relieved after symptomatic treatment was given. The breast satisfaction rate, the tumor local recurrence rate, distant metastasis rate, and 5-year survival for the breast-conserving group were 91.7% , 12.5% , 8.3% and 87.5% , respectively. For the control group, the counterparts were 0, 5.7% , 20% and 88.6%. Conclusion BCT is a safe and feasible choice for intermediate and advanced breast cancer patients who meet the standards of breast-conserving indications after NAT （ TAC regimen） .
出处
《临床军医杂志》
CAS
2013年第3期224-226,共3页
Clinical Journal of Medical Officers
关键词
新辅助化疗
保乳术
乳腺肿瘤
neoadjuvant chemotherapy
breast-conserving therapy
breast tumor
