乳腺癌患者综合治疗疗效及预后分析.docVIP

乳腺癌患者综合治疗疗效及预后分析 　　[摘要] 目的：探讨可手术的乳腺癌患者综合治疗的疗效、预后及主要影响因素。方法：收集2002年1月~2005年12月236例可手术的乳腺癌患者的临床病理资料，探讨患者的年龄、绝经与否、肿瘤大小、腋窝淋巴结转移数量、TNM分期、激素受体表达情况、化疗、放疗及内分泌治疗的疗效与预后的相关性。结果：236例患者5年生存率为68.6%。肿瘤大小、腋窝淋巴结转移数目及TNM分期与患者生存率呈负相关（P0.05）。结论：肿瘤大小、腋窝淋巴结转移数目、TNM分期、三阴性乳腺癌以及术后是否进行化疗、内分泌治疗、放射治疗均与预后有密切关系。其中肿瘤大小、腋窝淋巴结转移数目和TNM分期为影响乳腺癌患者预后的独立危险因素。 　　[关键词] 乳腺癌；综合治疗；预后 　　[中图分类号] R737.9 [文献标识码] Ａ [文章编号] 1673-7210（2011）06（c）-069-03 　　 　　Clinical analysis of synthetic therapy effect and prognostic factors in breast cancer patients 　　SHEN Weijuan1,3, LING Lijun2 　　1.Nanjing Medical University, Nanjing 210029, China; 2.Department of Breast Cancer, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China; 3.Department of Breast Cancer, the Affiliated Wujin Hospital of Jiangsu University, Changzhou 213000, China 　　[Abstract] Objective: To analyze the synthetic therapy effect and prognostic factors in the patients with breast cancer. Methods: From January 2002 to December 2005, the clinical-pathological materials of 236 breast cancer patients who had received synthetic therapy, including surgery, chemotherapy, endocrine therapy and radiotherapy were analyzed. The corre-lation of age, menopausal status, tumor size, axillary lymphnodal status, TNM stage, hormone receptor status, chemotherapy, endocrine therapy and radiotherapy with prognosis of breast cancer were evaluated. Results: The 5-year survival rates for patients was 68.6%. Analysis revealed that 5-year survival rates of this group were significantly associated with tumor size, axillary lymph nodal status and TNM stage (P 本文为全文原貌 未安装PDF浏览器用户请先下载安装 原版全文 　　术后是否进行辅助化疗，一般分为低危复发风险，中危复发风险和高危复发风险，低危复发风险患者可以不用化疗，但需满足以下要求：淋巴结阴性，肿瘤35岁，肿瘤无外周血管浸润，HER-2无过度表达。术后有201例有辅助化疗指征，其中，181 例行辅助化疗4～6疗程，20例未行辅助化疗。化疗方案以蒽环类药物为主，包括CEF、CAF、AC 方案，有部分腋窝淋巴结阳性的患者选用了包含紫杉类药物的方案，包括TAC、TA方案。有136 例ER（+）或PR（+）的患者有内分泌治疗的指征，其中84例进行了内分泌治疗，有60例服用了三苯氧胺3～5年，有24 例服用了芳香化酶抑制剂（来曲唑）。150例术后有放疗指征，其中116例行术后放疗。放疗的适应证：行保乳手术的患者；原发肿瘤≥5 cm；腋窝淋巴结转移数目≥4个；手