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目的观察CEF(环磷酰胺+表阿霉素+氟尿嘧啶)与TE(紫杉醇+表阿霉素)剂量密集方案治疗原发性乳腺癌新辅助化疗的临床疗效和不良反应。方法应用CEF与TE双周剂量密集化疗方案对62例女性Ⅱa～Ⅲc期原发性乳腺癌患者进行新辅助化疗。结果CEF组临床有效率为61.3%,病理完全缓解率为6.5%,疾病进展为3.2%;TE组分别为87.1%、9.7%。Ⅱb～Ⅲc期的局部进展期乳腺癌,CEF组RR为60.7%,TE组为85.2%,两组间临床疗效有显著性差异(P<0.05)。TE组主要的不良反应为骨髓抑制、中性粒细胞减少,Ⅲ度不良反应发生率为61.3%,Ⅳ度为6.5%;CEF组较TE组轻,其Ⅲ度不良反应发生率为45.2%,无Ⅳ度不良反应发生。此外,TE组神经毒性和肌肉关节痛发生率高于CEF组。其他不良反应程度均相对较轻。结论对Ⅱb～Ⅲc的局部进展期乳腺癌TE剂量密集方案近期临床疗效明显优于CEF方案。
Objective To observe the clinical efficacy and side effects of neoadjuvant chemotherapy of CEF (cyclophosphamide + epirubicin + fluorouracil) and TE (paclitaxel + epirubicin) in the intensive chemotherapy of primary breast cancer. Methods Sixty-two women with stage Ⅱa-Ⅲc primary breast cancer undergoing neoadjuvant chemotherapy were treated with double-weekly intensive intensive chemotherapy with CEF and TE. Results The clinical effective rate was 61.3% in CEF group, the pathological complete remission rate was 6.5% and the disease progression was 3.2%. The TE group was 87.1% and 9.7% respectively. In stage Ⅱb-Ⅲc, the prognosis of locally advanced breast cancer was 60.7% in CEF group and 85.2% in TE group, with significant difference (P <0.05). The main adverse reactions in TE group were myelosuppression, neutropenia, the incidence of Ⅲ degree adverse reactions was 61.3%, and the degree of Ⅳ was 6.5%. The CEF group was lighter than TE and the incidence of Ⅲ degree adverse reactions was 45.2% No grade IV adverse reactions occurred. In addition, the incidence of neurotoxicity and muscular joint pain in TE group was higher than that in CEF group. Other adverse reactions are relatively mild. Conclusions The recent clinical efficacy of TE dose-intensive chemotherapy for locally advanced breast cancer of stage IIb-Ⅲc is significantly better than that of CEF.