CEF 100序贯多西紫杉醇新辅助化疗治疗局部进展期乳腺癌的近期疗效

Neoadjuvant chemotherapy with FEC 100 followed by docetaxel for locally advanced breast cancer

关键词:  局部晚期乳腺癌  新辅助化疗  CEF 100  多西紫杉醇

Key words:  locally advanced breast cancer  neoadjuvant chemotherapy FEC 100  docetaxel

摘要:

［目的］观察4个CEF 100序贯4个多西紫杉醇新辅助化疗方案对局部晚期乳腺癌（LABC）的近期疗效。［方法］2002年4月~2005年1月，在法国土鲁兹的Claudius Regaud Institute肿瘤中心，45例均有组织学诊断证实的局部晚期乳腺癌给以行新辅助化疗，化疗方案为4个周期的CEF 100（Epirubicin 100 mg/m²，5-Fu 500 mg/m²，Cyclophosphamide 500 mg/m²），每3周为1个周期,然后序贯4个周期的多西紫杉醇（100 mg/m²），每3周为一个周期，共8个周期。［结果］4个CEF100方案后临床CR11例(24%)，PR18例(40%)，临床有效率为(CR+PR)64%，SD16(36%)例。序贯多西紫杉醇化疗后临床CR 27例（60%），PR 13例（29%），总有效率为89%，SD 4例（9%），PD 1例（2%）。26例实施了保乳手术，保乳率为57.8%，29例进行了根治手术。病理完全缓解pCR 16例（36%）。［结论］CEF 100序贯多西紫杉醇的新辅助化疗方案以及8个周期的新辅助化疗具有更高的临床缓解率以及病理完全缓解率。

Abstract:

［Objective］To evaluate the responseof neoadjuvant chemotherapy with FEC 100 followed by docetaxel for locally advanced breast cancer(LABC). ［Methods］Since April 2002,in institution of Toulouse ,45 women with LABC, non inflammatoty ,non metastatic,histologically proven breast carcinoma were treated with neoadjuvant chemotherapy. Sequential schedule wasFEC 100 (Epirubicin100mg/m²，5-Fu 500 mg/m²，Cyclophosphamide 500 mg/m²)×4 cyclesthen docetaxel 100 mg/m²×4 cycles, every 3 weeks. Thereafter,all patients surgery then radiotherapy and hormonotherapy when appropriate. ［Results］Clinical response after FEC:CR 11 patients (24%)，PR 18patients (40%)，OR (CR+PR)64%，SD 16 patients (36%).After Docetaxel: CR 27patients（60%），PR 13 patients（29%），OR 89%，SD 4 patients（9%），PD 1 patient（2%）.26 patients (57.8%) underwent conservative surgery，29 patients underwent mastectomy. Pathological response (pCR) was 35.6%（16 patients）. ［Conclusion］The increase of the clinical OR from 64% after FEC to 89% after docetaxel comfirms that sequential treatment including andracyclines then docetaxel demonstrated higher pathological response rate and better outcome than andracycline exclusive treatement. The administration of 8 cycles of chemotherapy is more effective than 4 cycles only.The 35.6% pathological CR rate,obtained with sequential FEC 100 followed by docetaxel is similar to the reported data from large clinical studies. Neoadjuvant sequential treatment with andracyclines and doxotaxel is feasible and very active in clinical practice for locally advanced breast cancer LABC.