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Received:April 15, 2022 Published Online:September 20, 2022
Received:April 15, 2022 Published Online:September 20, 2022
中文摘要: 目的 探讨表柔比星联合环磷酰胺序贯每周紫杉醇(EC-wP)新辅助化疗治疗人表皮生长因子受体2(HER2)阴性乳腺癌患者的疗效,分析患者治疗后复发转移的危险因素。方法 选取安庆第一人民医院2017年1月至2020年2月205例单侧原发性HER2阴性乳腺癌接受新辅助化疗患者,随机分为观察组(n=102)与对照组(n=103),观察组给予EC-wP治疗,对照组给予表柔比星联合环磷酰胺序贯多西他赛(EC-T)方案治疗,两组新辅助化疗结果后均接受手术治疗。比较两组临床治疗效果与不良反应发生情况,对患者术后进行2年随访,分析疾病复发转移的危险因素。结果 观察组新辅助化疗治疗有效率高于对照组(76.47% vs 63.11%,P<0.05);两组血小板减少、贫血、胃肠道反应、肝功能损害、肾功能损害、肺功能损害、心功能损害、脱发毒副反应发生情况比较差异无统计学意义(P>0.05);观察组中性粒细胞减少程度情况较对照组轻微(P<0.05);观察组和对照组2年无进展生存率比较差异无统计学意义[80.39%(82/102) vs 77.67%(80/103),P>0.05]。Logisitic回归分析显示,肿瘤直径≥3 cm、TNM分期高、术前淋巴结转移是观察组患者术后2年复发转移的危险因素,接受内分泌治疗是患者无进展生存的保护因素(P<0.05, P<0.01)。结论 EC-wP新辅助化疗治疗HER2阴性乳腺癌疗效显著,安全性高,肿瘤直径大、治疗前已存在淋巴结转移、临床分期高是患者是术后2年复发转移的危险因素,术后接受内分泌治疗是无进展生存的保护因素。
Abstract:Objective To explore the curative effect of epirubicin/cyclophosphamide (EC) and sequential weekly paclitaxel(wP) neoadjuvant chemotherapy (NC) on patients with HER2 negative breast cancer and the risk factors of recurrence and metastasis after treatment. Methods A total of 205 patients with primary unilateral HER2 negative breast cancer undergoing neoadjuvant chemotherapy between January 2017 and February 2020 were selected and were randomly divided into observation group (receiving EC-wP regimen, n=102) and control group [receiving EC-T (taxotere) regimen, n=103]. The surgical treatment were performed after neoadjuvant chemotherapy for patients in two groups. The clinical curative effect and adverse reactions were compared between two groups. The patients were followed up for 2 years after operation to analyze the risk factors of disease recurrence and metastasis. Results The effective rate of NC in observation group was statistically higher than that in control group (76.47% vs 63.11%, P<0.05). There was no statistical difference in the incidence of side effects (thrombocytopenia, anemia, gastrointestinal reactions, liver function damage, renal function damage, lung function damage, cardiac function damage and alopecia) between two groups (P>0.05). The degree of neutropenia in observation group was slighter than that in control group (P<0.05). There was no statistical difference in 2-year progression-free survival rate between observation group and control group [80.39% (82/102) vs 77.67% (80/103), P>0.05]. Logisitic regression analysis showed that tumor diameter ≥3 cm, high TNM staging and preoperative lymph node metastasis were the risk factors for recurrence and metastasis of breast cancer patients at 2 years after EC-wP neoadjuvant chemotherapy. Endocrine therapy was a protective factor for progression-free survival(P<0.05,P<0.01). Conclusion EC-wP neoadjuvant chemotherapy has significant curative effect and high safety in the treatment of HER2 negative breast cancer.
keywords: Breast cancer Human epidermal growth factor receptor 2 negative Neoadjuvant chemotherapy Epirubicin Cyclophosphamide Paclitaxel Recurrence Metastasis
文章编号: 中图分类号:R737.9 R453 文献标志码:A
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