紫杉类药物辅助化疗对Ⅱ、Ⅲ期浸润性乳腺癌疗效的临床观察

Effects of adjuvant chemotherapy including paclitaxel for operable breast cancer in the Ⅱ and Ⅲ Stage

关键词:  乳腺癌  辅助化疗  紫杉类

Key words:  breast cancer  adjuvant chemotherapy  paclitaxel

摘要:

［目的］比较蒽环类加紫杉类药物与单用蒽环类方案辅助化疗对Ⅱ、Ⅲ期浸润性乳腺癌患者疗效的影响。［方法］选取2004年1月～2009年1月乳腺癌术后Ⅱ、Ⅲ期患者161例，分析其临床特征、病理学特征及化疗方案与复发转移率的关系，并进一步分析紫杉类药物化疗对ER、PR阴性患者的疗效。［结果］随访至2010年3月，总复发转移率为24.8%（40/161），死亡率为5%。Ⅱ期患者复发转移率为18%，Ⅲ期患者为40%；其中蒽环类加紫杉类辅助化疗者与单纯蒽环类辅助化疗者的复发转移率为14.8%（12/81）和35%（28/80），两组差异有显著性意义（P<0.05）；ER、PR均阴性的患者44例，加紫杉类与单用蒽环类辅助化疗患者的复发转移率分别为12%（3/25）和52.6%（10/19），两组差异有显著性意义（P<0.05）。［结论］在常规蒽环类化疗方案中加入紫杉类药物可以降低Ⅱ、Ⅲ期乳腺癌患者的复发风险，特别对ER、PR均阴性的患者有明显无病生存优势。

Abstract:

［Objective］To investigate the effects of adjuvant chemotherapy including paclitaxel for the Ⅱ and Ⅲ stage breast cancer.［Methods］From January 2004 to January 2009,161 patients with postoperative breast cancer were followed up,and the relationship between clinical feature,hormone receptor,regimen and recurrent metastatic rate were analyzed retrospectively.［Results］Following up to March 2010,the total recurrent metastatic rate was 24.8%(40/161) and the mortality was 5%.The recurrent metastatic rates of the Ⅱ stage and Ⅲ stage patients were 18% and 40% respectively.And for the patients received anthracycline-based combinations or plus paclitaxel,the recurrent metastatic rates were 35%(28/80) and 14.8%(12/81)respectively(P<0.05).The ER and PR were poor in 44 cases,in that the patients received chemotherapy using anthracyclines only and with paclitaxel,the recurrent metastatic rates were 52.6%(10/19) and 12%(3/25) respectively(P<0.05).［Conclusion］Adjuvant chemotherapy including paclitaxel on patients with Ⅱ and Ⅲ stage breast cancer can reduce the recurrent metastatic rate,especially for the patients with the ER-poor and PR-poor.