目的 观察多西他赛、环磷酰胺(DC方案)与多西他赛、吡柔比星(DT方案)新辅助化疗方案治疗局部晚期乳腺癌的临床疗效和不良反应.方法 经麦默通穿刺确诊局部晚期乳腺癌可手术患者73例,随机分为DC组(35例),DT组(38例),分别给予DC方案,DT方案化疗3个周期,DC组35例,DT组38例化疗结束2周后行乳腺癌改良根治术.比较DC组,DT组疗效和不良反应,治疗前、后TNM分变化、术后并发症及化疗前后ER、PR、HER2变化比较.结果 临床疗效比较DT组优于DC组,其差异有统计学意义(P<0.05);TNM分期均较新辅助化疗前降低(P<0.05),不良反应比较差异无统计学意义(P>0.05);术后并发症比较差异无统计学意义(P>0.05),ER、PR均为阴性患者对化疗敏感,DT方案对于HER2高表达患者疗更敏感.结论 DT及DC新辅助化疗方案疗对局部晚期乳腺癌均有效,DT方案优于DC方案.%Objective To observe the clinical efficacy and adverse reactions of two neoadjuvant chemotherapy regimens for locally advanced breast cancer ( LABC ), docetaxel + cyclophosphamide ( DC plan) and docetaxel + THP( DT program).Methods A total of 73 operable patients with LABC diagnosed by the mammotome biopsy were randomly divided into DC group (39 cases), DT group (44 cases), which were treated with DC plan or DT program for 3 cycles respectively.Thirty - five cases in DC program and 38 cases in DT program received modified radical mastectomy 2 weeks after chemotherapy.The efficacy and adverse reactions ,TNM points before and after the treatment, postoperative complications and ER, PR,HER2 changes before and after chemotherapy were compared between the two groups.Results Clinical efficacy of DT group was better than that of DC group, and the differences were statistically significant( P＜0.05 ); TNM stage of both groups were lower after neoadjuvant chemotherapy( P ＜ 0.05 ) , and adverse reactions and postoperative complications had no significant difference( P ＞0.05 ) ;Patients negative for ER and PR were sensitive to chemotherapy, and those with HER2 overexpression were more sensitive to DT treatment.Conclusion DT and DC are both effective to LABC ,and DT scheme is superior to DC plan.
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