多西他赛联合表柔比星、环磷酰胺和氟尿嘧啶治疗局部晚期乳腺癌_临床医学论文.docVIP

多西他赛联合表柔比星、环磷酰胺和氟尿嘧啶治疗局部晚期乳腺癌_临床医学论文 多西他赛联合表柔比星、环磷酰胺和氟尿嘧啶治疗局部晚期乳腺癌_临床医学论文 【摘要】 目的：观察多西他赛联合表柔比星、环磷酰胺、氟尿嘧啶(DECF方案)新辅助化疗治疗局部晚期乳腺癌 (locally advanced breast cancer，LABC)疗效及毒副反应。方法：2005年8月—2007年9月收治的26例LABC患者，均为女性。中位年龄46岁(30~72岁), Ⅲa期16例,Ⅲb期10例,化疗剂量为多西他赛80 mg/m2、表柔比星60 mg/m2、环磷酰胺500 mg/m2和氟尿嘧啶500 mg/m2静脉滴入, 每3周为1个周期, 2个周期后评价疗效，并决定是否继续1~2个周期DECF方案后再接受手术或放疗。化疗后48 h预防性应用细胞集落刺激因子(G-CSF)。结果：26例患者接受2~4个周期DECF方案的新辅助化疗。治疗后完全缓解5例,部分缓解15例,稳定4例,进展2例,有效率76.9%(20/26),病理完全缓解率、临床完全缓解率和临床部分缓解率分别为11.5%、19.2%和57.7%，本组的手术切除率为96%。主要毒副反应为白细胞减少,Ⅲ~Ⅳ度白细胞减少的发生率分别占总周期数的12.5%和15.0%,其他不良反应为轻、中度的脱发、恶心或呕吐、肌肉关节酸痛、体液潴留、疲乏、腹痛等。结论：DECF方案是LABC的一种安全有效的新辅助化疗方案。 【关键词】 乳腺肿瘤·抗肿瘤联合化疗方案·多西他赛·表柔比星·环磷酰胺·氟尿嘧啶 　　【ABSTRACT】 Objective: To investigate the therapeutic effect and side reaction of new adjuvant chemotherapy with docetaxel(D) Epirubicin(E) cytoxan(D) 5-FU(F) for locally advanced breastcancer(LABC). Methods: 26 women(2005.8~2007.9)with LABC were treated, median age was 46(30~72age).16 patients were in clinical stageⅢa, 10 in stageⅢb. The dosage were 80mg/m2(Docetaxel), 60 mg/m2 (Epirubicin), 500mg/m2(cytoxan) and 500mg/m(25-FU) every 3 weeks. After 2~4 cycles of DECF application, the therapeutic effect and side reaction were evaluated by investigators for each patient to decide whether she should receive another 1~2 cycles of DECF before re-surgery or radiation therapy. G-CSF was Prophylactically used at 48hs after chems. Results: 26 patients received 2~4 cycles of DECF protocol. (CR)5 cases, (PR)15 cases, (SD)2 cases, (PD)4cases, and the effective rate(CR+PR) was 76.9%(20/26).The pathological complete response (PCR), clinical complete response (CCR) and clinical partial response (CPR) rates were 14·3%, 21·4% and 53·6% respectively. Tumor operation rate was 96% in this group. The major toxicity included neutropenia，and Grade Ⅲ~Ⅳneutropenia was 12.5% and 15.0% of the total cycle. The other adverse events were alopecia, nausea, vomiting, myalgia and arthralgia ,fluid retention, lassitude, abdominal pain ,which