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目的 :1)探讨NE方案作为乳腺癌新辅助化疗 (术前化疗 )的疗效及不良反应 ;2 )比较NE方案作为新辅助化疗和辅助化疗 (术后化疗 )对乳腺癌患者不良反应的差别。方法 :对原发肿块 >3cm的可手术乳腺癌患者采用单盲及随机对照的方法进行分组研究。新辅助化疗组术前予以 3个周期NE方案化疗 ,然后行改良根治术 ,术后再用NE方案化疗 3个周期。辅助化疗组先行改良根治术 ,术后用NE方案化疗 6个周期。结果 :新辅助化疗组CR 5 16例 (31 2 5 % ) ,PR 7 16例 (4 3 75 % ) ,总有效率 75 %。新辅助化疗组和辅助化疗组的主要严重不良反应分别为白细胞减少 (83 33%、88 2 4 % )、血小板减少(2 2 2 2 %、2 3 5 3% )、血红蛋白降低 (16 6 7%、17 6 5 % )、谷丙转氨酶升高和 或谷草转氨酶升高(11 11%、11 76 % )、恶心呕吐 (2 7 78%、2 3 5 3% )、腹痛和 或腹泻 (5 5 6 %、0 % )及脱发 (2 7 78%、35 2 9% ) ;两组的不良反应发生率差异无显著意义 ,P >0 0 5。结论 :NE作为乳腺癌的新辅助化疗方案具有良好疗效 ,不良反应可以耐受。
Objectives: 1) To explore the efficacy and adverse reactions of NE regimen as neoadjuvant chemotherapy (preoperative chemotherapy) for breast cancer; 2) to compare the adverse effects of NE regimen as neoadjuvant chemotherapy and adjuvant chemotherapy (postoperative chemotherapy) on patients with breast cancer. Methods: A single blind and randomized controlled study was performed in patients with operable breast cancer of primary mass> 3 cm. The neoadjuvant chemotherapy group was given 3 cycles of NE regimen preoperatively, followed by modified radical mastectomy and 3 cycles of NE regimen postoperatively. Adjuvant chemotherapy group first modified radical mastectomy, NE chemotherapy after 6 cycles. Results: In the neoadjuvant chemotherapy group, 16 cases (31.25%) had CR5, and 16 cases (43.5%) had PR7, with a total effective rate of 75%. The major adverse reactions in the neoadjuvant chemotherapy and adjuvant chemotherapy groups were leukopenia (83 33%, 88 2 4%), thrombocytopenia (22 22%, 23 35%) and hemoglobin (16 6 7 (11 11%, 11 76%), nausea and vomiting (27 78%, 23 35%), abdominal pain and / or diarrhea (5%), elevated alanine aminotransferase and or aspartate aminotransferase 5 6%, 0%) and hair loss (27 78%, 35 2 9%). There was no significant difference in the incidence of adverse reactions between the two groups (P> 0.05). Conclusion: NE as a neoadjuvant chemotherapy regimen for breast cancer has a good curative effect and adverse reactions can be tolerated.