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目的 :探讨新辅助化疗TP方案(顺铂联合多西他赛)对基底细胞样型乳腺癌(basal-like breast cancer,BLBC)患者的疗效及安全性。方法 :将2010年1月—2014年8月收治的88例BLBC患者随机分为FEC组(5-氟尿嘧啶+表柔比星+环磷酰胺)28例、TEC组(多西他赛+表柔比星+环磷酰胺)30例和TP组(多西他赛+顺铂)30例,进行新辅助化疗,分析3组患者的临床病理特征和新辅助化疗的疗效。结果 :年龄、原发肿瘤大小、腋窝淋巴结转移数目、临床分期和肿瘤组织学分级在3组患者间的差异无统计学意义(P>0.05)。TP组患者的病理完全缓解(pathologic complete remission,p CR)率和有效率(response rate,RR)均高于FEC组(P=0.005,P<0.001),TP组p CR率与TEC组间的差异无统计学意义(P>0.05),TP组的RR高于TEC组而疾病进展(progressive disease,PD)率低于TEC组(P值均<0.05)。TP组患者的3年无病生存(disease free survival,DFS)率和总生存(overal survival,OS)率高于FEC组及TEC组(P<0.001,P=0.018),TEC组的3年DFS率与FEC组间的差异无统计学意义(P>0.05),TEC组的3年OS率高于FEC组(P<0.05)。在新辅助化疗未获得p CR的患者中,TP组患者的3年DFS率和OS率均高于TEC组和FEC组(P值均<0.05)。3组患者不良反应间的差异无统计学意义(P>0.05)。结论:TP方案能提高BLBC患者新辅助化疗的p CR率、3年DFS率和OS率,不良反应可以耐受。
Objective: To investigate the efficacy and safety of neoadjuvant chemotherapy TP (cisplatin plus docetaxel) in patients with basal-like breast cancer (BLBC). Methods: Eighty-eight patients with BLBC admitted from January 2010 to August 2014 were randomly divided into FEC group (5-fluorouracil + epirubicin + cyclophosphamide), 28 patients with TEC, and docetaxel + epidural 30 cases of astragalosum + cyclophosphamide and 30 cases of TP group (docetaxel + cisplatin). Neoadjuvant chemotherapy was performed to analyze the clinicopathological features and the efficacy of neoadjuvant chemotherapy in the three groups. Results: There were no significant differences in age, primary tumor size, axillary lymph node metastasis, clinical stage and tumor histological grade between the three groups (P> 0.05). The pathologic complete remission (pCR) rate and response rate (RR) in TP group were higher than those in FEC group (P = 0.005, P <0.001) The difference was not statistically significant (P> 0.05). The RR of TP group was higher than that of TEC group and the rate of progressive disease (PD) was lower than that of TEC group (P <0.05). The 3-year disease free survival (DFS) and overal survival (OS) rates of TP group were higher than those of FEC group and TEC group (P <0.001, P = 0.018) There was no significant difference between rate and FEC group (P> 0.05). The 3-year OS rate of TEC group was higher than that of FEC group (P <0.05). The 3-year DFS rate and OS rate in TP group were higher than those in TEC group and FEC group (all P <0.05) in patients without neoadjuvant chemotherapy. There was no significant difference in adverse reactions between the three groups (P> 0.05). Conclusion: TP regimen can improve the neoadjuvant chemotherapy in patients with BLBC p CR rate, 3-year DFS rate and OS rate, adverse reactions can be tolerated.