摘要
目的评价表阿霉素(EPI)联合紫杉醇(TAX)进行新辅助化学治疗乳腺癌的疗效及不良反应.方法用EPI联合TAX治疗Ⅱ、Ⅲ期乳腺癌26例,其中EPI 60mg/m2,第1天静注,TAX150mg/m2,第2天持续3 h静滴,4周为1个疗程.所有患者化疗2个周期后行乳腺癌改良根治术,术后继续以原方案化疗4～6个周期.化疗前给予地塞米松、蒽丹西酮、苯海拉明和西米替丁预防胃肠道不良反应及过敏反应.结果乳腺癌有效率(RR)81%(21/26),其中Ⅱ期乳腺癌达94%(15/16),Ⅲ期为60%(6/10).无病理完全缓解病例,1例(4%)临床完全缓解(cCR),20例(77%)部分缓解(PR),5例(19%)无变化(NC),无进展病例.腋窝肿大淋巴结中62%(16/26)新辅助化疗后不能触及,其中N1达75%(15/20),N2为17%(1/6).主要不良反应为白细胞下降、关节肌肉痛、神经毒性、胃肠道反应、脱发和面色潮红,均可耐受.结论EPI联合TAX进行新辅助化疗是一种安全、有效、可行的方法,能明显缩小乳腺癌的原发肿瘤及腋窝淋巴结转移灶.
Objective To evaluate the efficacy and toxicity of neoadjuvant chemotherapy with epirubicin (EPI) plus paclitaxel (TAX) in treatment of patients with breast cancer. Methods Twenty - six patients with stage II , III breast cancer were treated with EPI 60mg/m by intravenous injection on day 1 and TAX 150 mg/m by 3 - hour continuous infusion on day 2 with 28 days as a cycle. All patients received 2 cycles of neoadjuvant chemotherapy followed by modified radical mastectomy and additional postoperative chemotherapy with the same regimen for 4 or 6 cycles. Premedications of dexamethasone, ondansetron, di-phenhydramine, and cimetidine were administered to prevent gastroenteric and allergic reactions before chemotherapy. Results For primary tumors of breast, the overall response rate (RR)was 81% (21/26), including 16 patients with stage II 94% (15/ 16), 10 patients with stage III 60% (6/10) . No case was pathologic complete response.One patient obtained clinical complete response (cCR), 20 (77%) partial response (PR) and 5 (19%) no change (NC), No case was progressive disease. For clinically involved axillary lymph nodes, 62% (16/26) were not palpable after neoadjuvant chemotherapy, including 75% (15/20) with N1 , 17% (1/6) with N2 .The major toxicities, including leukopenia, arthralgia, myalgia, neurotoxicity, gastroenteric reactions, alopecia, and flushing of face, were well tolerable. Conclusions Neoadjuvant chemotherapy with EPI plus TAX is safe, effective, and feasible, Which can result in significant shrinkage of primary tumors and axillary metastatic lymph nodes in breast cancer.
出处
《中国妇产科临床杂志》
2002年第1期30-32,共3页
Chinese Journal of Clinical Obstetrics and Gynecology
关键词
表阿霉素
紫杉醇
乳腺肿瘤
新辅助化疗
Epirubicin
Paclitaxel
Breast carcinoma
Neoadjuvant chemotherapy
