目的 对比不同新辅助化疗方案治疗三阴乳腺癌 (TNBC) 的疗效和对预后的影响.方法 将93例TNBC患者随机分为TP组 (多西他赛+卡铂) 47例和TAC组 (多西他赛+多柔比星+环磷酰胺) 46例.治疗6个周期后, 比较两组的化疗效果、不良反应、1年无进展生存期 (PFS) 、总生存期 (OS) 及Kamofsky评分.结果TP组和TAC组的总缓解率 (ORR) 分别为87.23％和86.95％, 差异无统计学意义 (P>0.05);TP组的临床完全缓解率 (46.81％) 和病理完全缓解率 (53.33％) 均高于TAC组 (21.74％、25.58％), 差异有统计学意义 (P<0.05);.TP组恶心、呕吐、脱发、白细胞减少、中性粒细胞减少和肝功能损害等不良反应的发生率均低于TAC组 (P<0.05) .两组患者的1年PFS、OS比较, 差异无统计学意义 (P>0.05);TP组化疗后Kamofsky评分显著高于TAC组 (P<0.05) .结论TP新辅助化疗方案治疗TNBC的总有效率和预后情况与TAC方案相当, 能显著提高临床完全缓解率, 降低不良反应发生率.%OBjECTIVE To compare the efficacy and prognosis of different neoadjuvant chemotherapy regimens in the treatment of triple negative breast cancer (TNBC). METHODS 03 patients with TNBC were randomly divided into TP group (docetaxel + carboplatin) and TAC group (docetaxel + doxorubicin + cyclophosphamide). After 6 cycles of treatment, the chemotherapy, adverse events, 1-year progression-free survival (PFS), overall survival (OS) and Kamofsky score were compared between these two groups. RESULTS The total effective rates of TP group and TAC group were 87.23％ and 86.95％, respectively, and there was no statistically significance between them (P>0.05). The clinical complete response rate (46.81％) and pathological complete remission rate (53.33％) in the TP group were higher than those in the TAC group (21.74％, 25.58％) with statistically significantce (P<0.05). The incidence of adverse reactions such as nausea and vomiting, alopecia, leukopenia, neutropenia and liver damage were all lower in the TP group than the TAC group (P<0.05). There was no significant difference in PFS and OS between these two groups (P>0.05), but the Kamofsky score was significantly higher in the TP group than the TAC group (P<0.05). CONCLUSION The total effective rate and prognosis of TP neoadjuvant chemotherapy for TNBC were comparable to those of TAC, which could significantly improve the rate of complete clinical remission and reduce the incidence of adverse reaction.
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