吡柔比星在III期原发性乳腺癌新辅助化疗中的近期效果观察
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海健

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Clinical study of neoadjuvant chemotherapy of pirarubicin in stage III primary breast carcinoma
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    摘要:

    目的:探讨以蒽环类药物吡柔比星(THP)为主的联合新辅助化疗对III期原发性乳腺癌新辅助化疗的近期临床效果。方法:对138例手术前确诊的III期原发性乳腺癌采用以吡柔比星为主的CTF方案化疗1~4个周期,观察临床疗效、保乳手术率和毒副反应。结果:全组总有效率为75.4%(104/138);其中完全病理缓解1例,临床完全缓解1例(0.7%),部分缓解102例(73.9%),无变化32例(23.2%),进展2例(1.4%)。实施保乳手术7例(5.1%)。施行化疗3+4周期的疗效和保乳手术率均明显高于1+2周期者(均P<0.05)。该方案的脱发反应轻,I度脱发28例(20.3%);心脏毒性较小,室性期外收缩发生率1.4%(2/138),无充血性心衰病例。但骨髓抑制较明显,总发生率55.8%(77/138),其中II度骨髓抑制发生率为27.5%(38/138),III度骨髓抑制发生率为21.0%(29/138),IV度骨髓抑制发生率为7.2%(10/138)。结论:以吡柔比星为主的CTF方案用于乳腺癌新辅助化疗心脏毒性小,近期疗效较满意;但骨髓抑制发生率高,治疗期间应予支持治疗。

    Abstract:

    Abstract:Objective:To investigate the shortterm effect of anthracycline(pirarubicin)based combination regimen as neoadjuvant chemotherapy for stage III primary breast cancer. Methods:For 138 patients with stage III primary breast cancer , one to four cycles of anthracyclinebased combination chemotherapy as CTF regimen were given. The clinical results, the feasibility rate of conservative breast surgery and toxic and side reaction were observed. Results:The overall response rate was 75.4%(104/138), including one case with clinical complete response(cCR), and 102 cases with clinial partial response(cPR),no change rate 23.2%, and progressive disease rate(PD) 1.4%(2/138). Seven cases received conservative breast surgery(5.1%,7/138). The cardiotoxicity was light without congestive heart failure, and the incidence of premature ventricular extrasystole(PVE) was 1.4%. The regimen resulted in mild alopecia and serious myelosuppression. The incidence of grade II myelosuppression was 27.5%, grade III 21.0%, and grade IV 7.2%.Conclusions:the shortterm effect of anthracyclinebased combination neoadjuvant chemotherapy as CTF regimen for primary breast cancer was satisfactory with little cardiotoxic effects.

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海健,毛杰,唐利立,申郑堂.吡柔比星在III期原发性乳腺癌新辅助化疗中的近期效果观察[J].中国普通外科杂志,2006,15(10):2-727.
DOI:10.7659/j. issn.1005-6947.2006.10.002

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  • 在线发布日期: 2006-10-25