紫杉醇脂质体用于乳腺癌新辅助化疗的疗效与安全性

摘要

目的:探讨紫杉醇脂质体用于乳腺癌新辅助化疗的疗效与安全性.方法:选取2013年3月-2015年2月河南省人民医院收治的行新辅助化疗与手术治疗的乳腺癌患者259例进行回顾性研究,根据治疗方法的不同,将患者分为A组118例、B组141例.A组患者采用紫杉醇脂质体联合表柔比星、环磷酰胺治疗,B组患者采用多西他赛联合表柔比星、环磷酰胺治疗.比较两组患者的临床疗效、2年生存情况与不良反应发生情况的差异.结果:A组患者的总有效率、疾病控制率分别为80.5％ (95/118)、95.8％ (113/118),B组分别为79.4％(112/141)、92.9％(131/141),两组的差异均无统计学意义(P＞0.05).两组患者2年生存率的差异无统计学意义(P=0.368).A组患者Ⅲ-Ⅳ级中性粒细胞减少症、Ⅲ-Ⅳ级白细胞减少症、过敏反应、体液潴留、口腔黏膜炎、皮肤指甲毒性反应的发生率明显低于B组,差异均有统计学意义(P＜0.05).结论:紫杉醇脂质体用于乳腺癌新辅助化疗的疗效与多西他赛相当,但紫杉醇脂质体减少了溶剂降解引起的过敏反应,不良反应更少.%OBJECTIVE:To probe into the efficacy and safety of paclitaxel liposome in neoadjuvant chemotherapy for breast cancer.METHODS:259 patients with breast cancer accepting neoadjuvant chemotherapy and operation admitted into People's Hospital of Henan from Mar.2013 to Feb.2015 were selected to be divided into group A (118 cases) and group B (141 cases) via the different treatment methods,retrospective analysis was conducted on two groups.Patients in group A were treated with paclitaxel liposome combined with epirubicin and cyclophosphamide,while patients in group B received docetaxel combined with epirubicin and cyclophosphamide.Differences of clinical efficacy,2-year survival rate and incidence of adverse drug reactions of two groups were compared.RESULTS:The total effective rate,disease control rate of group A were respectively 80.5 ％ (95/118) and 95.8％ (113/118),and the data in group B were respectively 79.4％ (112/141) and 92.9％ (131/141),without any statistically significant difference between two groups (P ＞ 0.05).There was no statistical significance between two groups in the 2-year survival rate(P =0.368).The incidences of Ⅲ-Ⅳ grade of neutrophilic granulocytopenia,Ⅲ-Ⅳ grade of leukopenia,anaphylaxis,fluid overload,oral mucositis and toxic reaction of skin,hair and nails in group A were significantly lower than those in group B,with statistical significance difference (P ＜ 0.05).CONCLUSIONS:The efficacy of paclitaxel liposome is equivalent to docetaxel,yet paclitaxel liposome can reduce the allergic reactions caused by degradation of solvent and has fewer adverse drug reactions.