TAC与TP方案治疗三阴性乳腺癌的临床观察

摘要

Objective To compare the efficacy and adverse events of TAC and TP regimens as neoadjuvant chemotherapy for triple negative breast carcinoma( TNBC). Methods One hundred and two cases of TNBC patients with pathological diagnose were divided into TAC group(52 cases) and TP group(50 cases). TAC group:docetaxel 75mg/m2 or taxol 135mg/m2 iv d1, ADM 40mg/m2 or epirubicin 75mg/m2 iv d2 ,CTX 600mg/m2 iv d1 ;TP group: docetaxel 75mg/m2 or taxol 135mg/m2 iv d1 ,cisplatin 30mg/m2 iv d2-d4. All patients were operated after neoadjuvant chemotherapy for 2-4 cycles at a interval of 21 days. The efficacy and adverse reaction were evaluated. Results In TAC group, 5 cases gained pathological complete response,35 cases gained partial response,9 cases was stable. In TP group, 4 cases gained pathological complete response, 32 cases gained partial response, 5 cases was stable. There was no significant difference in the pathological complete response rate between two groups ( P = 0. 774) , and the overall response rate(RR) was with no significant difference too(P =0. 568). There were 12 cases with progressive disease after chemotherapy for 2 cycles, 3 cases in TAC group and 9 cases in TP group. There were 2 cases with atrial extrasystoles in TAC group, 3 cases with impairment of kidney in TP group. 3-4 degree toxicity of hematologic rate and alopecia rate in TAC group were higher than those of TP group; but 3-4 degree incidence rate of gastrointestinal reaction in TP group were higher than that in TAC group. There were significant statistical differences(P=0. 000). Conclusion TAC and TP regimens for triple negative breast cancer patients is effective and well tolerated.%目的 比较新辅助化疗TAC与TP方案治疗三阴性乳腺癌(TNBC)的疗效和安全性.方法 102例三阴性乳腺癌患者均经病理组织学确诊,分为TAC组(52例)和TP组(50例).TAC组:多西他赛75mg/m2或紫杉醇(紫杉醇脂质体)135mg/m2 iv,d1；吡柔比星40mg/m2或表柔比星75mg/m2 iv,d2；环磷酰胺600mg/m2 iv,d1.TP组:多西他赛75mg/m2或紫杉醇(紫杉醇脂质体)135mg/m2 iv,d1；顺铂30mg/m2 iv,d2～d4.21天为1周期,化疗2～4个周期后行手术治疗.评价两组近期疗效和毒副反应.结果 TAC组获pCR 5例(9.6％),PR 35例(67.3％),SD 9例(17.3％),RR为76.9％；TP组获pCR 4例(8.0％),PR 32例(64.0％),SD 5例(10.0％),RR为72.0％,两组pCR率和RR差异均无统计学意义(P＞0.05).102例患者中12例经2个周期化疗后肿瘤进展,其中TAC组3例,TP组9例.TAC组有2例发生房性前期收缩,TP组3例发生2级肾功能损伤.TAC组3～4级血液学毒性和脱发的发生率明显高于TP组,但TP组的3～4级胃肠道反应发生率高于TAC组.结论 TAC方案与TP方案在三阴性乳腺癌新辅助化疗中均具有一定疗效,不良反应尚可耐受.