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目的:评价白蛋白结合型紫杉醇、表柔比星联合环磷酰胺对比多西他赛、表柔比星联合环磷酰胺新辅助化疗治疗三阴性乳腺癌的临床效果。方法:将东莞市人民医院2009-01-03-2012-01-31经病理学确诊的三阴性乳腺癌患者42例分为PEC组21例,给予白蛋白结合型紫杉醇260 mg/m2,静脉滴入,表柔比星70 mg/m2,静脉滴入,环磷酰胺500mg/m2,静脉滴入,3周重复,不做抗过敏预处理;TEC组21例,给予多西他赛75mg/m2,静脉滴入,表柔比星与环磷酰胺应用方法同PEC方案,3周重复,使用多西他赛前1d开始口服地塞米松片7.5mg,2次/d,连服3d。结果:两组患者均完成4个周期新辅助化疗。PEC组RR 19例(90.5%)、CR 8例(38.1%)、PR 11例(52.4%)、SD 2例(9.5%);TEC组RR 18例(85.7%)、CR 8例(38.1%)、PR 10例(47.6%)和SD 3例(14.3%),两组差异均无统计学意义,P>0.05;PEC组pCR为28.6%优于TEC组的19.1%,P=0.049。随访截止2013-04-01,中位随访时间25个月(12~48个月),随访率为100.0%。毒副作用两组中性粒细胞下降、血小板减少、便秘、心脏毒性、肝功能异常、外周神经毒性、肝肾功能异常发生率相比差异均无统计学意义,P>0.05。结论:白蛋白结合型紫杉醇、表柔比星联合环磷酰胺新辅助治疗局部晚期三阴性乳腺癌疗效显著,毒副作用可耐受,值得进一步研究。
OBJECTIVE: To evaluate the clinical effects of combination therapy of albumin-bound paclitaxel, epirubicin and cyclophosphamide versus docetaxel, epirubicin combined with cyclophosphamide, and neoadjuvant chemotherapy for triple negative breast cancer. METHODS: Twenty-two patients with triple-negative breast cancer confirmed by pathology at Dongguan City People’s Hospital from January 2009 to March 2012 were included and divided into 21 patients in the PEC group. Albumin-binding paclitaxel 260 mg/m2 was administered intravenously. Infusion, Epirubicin 70 mg/m2, Intravenous infusion, Cyclophosphamide 500 mg/m2, Intravenous infusion, Repeated in 3 weeks, No anti-allergic preconditioning; 21 cases in TEC group, given docetaxel 75 mg/m2 , Intravenous instillation, application method of epirubicin and cyclophosphamide with PEC protocol, 3 weeks repeat, using docetaxel 1d before oral dexamethasone tablets 7.5mg, 2 times / d, and even served 3d. Results: Both groups completed 4 cycles of neoadjuvant chemotherapy. In the PEC group, RR was 19 (90.5%), CR was 8 (38.1%), PR was 11 (52.4%), SD was 2 (9.5%); TEC group RR was 18 (85.7%), CR was 8 (38.1%) ), PR 10 cases (47.6%) and SD 3 cases (14.3%), the difference between the two groups were not statistically significant, P> 0.05; PEC group pCR was 28.6% better than TEC group 19.1%, P = 0.049. The follow-up period was 2013-04-01, the median follow-up time was 25 months (12-48 months), and the follow-up rate was 100.0%. There were no statistically significant differences in neutropenia, thrombocytopenia, constipation, cardiotoxicity, abnormal liver function, peripheral neurotoxicity, and abnormal liver and kidney function between the two groups (P>0.05). Conclusion: The combination of albumin-bound paclitaxel and epirubicin combined with cyclophosphamide is effective in the treatment of locally advanced triple negative breast cancer. The toxic and side effects are tolerable and worthy of further study.