目的 通过丑时化疗与普通时间化疗对乳腺癌患者血液学及非血液学毒性的比较,评价丑时化疗是否具有减毒作用及其安全性.方法 将已确诊的乳腺癌患者随机分成2组,观察组30例,对照组30例,每组完成3程TAC(多西他赛+多柔比星+环磷酰胺)/TEC(多西他赛+表柔比星+环磷酰胺)方案新辅助化疗,观察组丑时(1:00-3:00)化疗,对照组普通时间(14:30-17:30)化疗.定时观察血液分析、肝功能及恶心、呕吐情况,评估化疗毒副作用,通过监测患者化疗过程中的血常规、肝肾功能、心电图、心脏彩超等指标评价丑时化疗的安全性.结果 在第1、第2、第3程TAC/TEC化疗过程中,观察组恶心、呕吐程度均低于对照组,观察组白细胞、中性粒细胞水平均高于对照组(P<0.05).在第1、第2、第3程TAC/TEC化疗的任一疗程中,血红蛋白、血小板、氨基转移酶(ALT、AST)两组差异无统计学意义(P>0.05).安全性分析:除相关监测指标外,在过敏反应、心脏毒性及外周神经系统毒性、肾毒性等副作用方面,两组均未发生影响生命安全事件.结论 丑时化疗在减轻TAC/TEC新辅助化疗所导致的恶心、呕吐方面优于普通时间化疗,在减轻血液学毒性相关粒细胞、白细胞缺乏方面优于普通时间化疗.丑时化疗能有效缓解部分TAC/TEC新辅助化疗所导致的毒副作用,此方法安全可行.%Objective To evaluate the hematology and non hematologic toxicity and its safety of Choushi (1:00-3:00) chemotherapy through the comparison of Choushi chemotherapy and regular time chemotherapy. Methods The patients of breast cancer were randomly divided into two groups, 30 cases in the observation group and 30 cases in the control group. The two groups were given three courses of TAC/TEC regimens. The observation group was given chemotherapy at Choushi (1:00-3:00), the control group was received chemotherapy at regular time (14:30-17:30). The safety and toxicities of Choushi chemotherapy was evaluated by monitoring the blood routine, hepatic and renal function, nausea, electrocardiogram of patients. Results In three TAC/TEC chemotherapy courses, the degree of nausea and vomiting in observation group was lower than the control group (P<0.05). The hemoglobin, platelet, and aminotransferase (ALT, AST) between the two groups were not signifi-cantly different (P>0.05). Besides monitoring indicators, there was no trend of accidents, such as allergic reactions, cardiac toxicity and the peripheral nervous system toxicity and renal toxicity. Conclusion Choushi chemotherapy is better than regular chemotherapy in reducing nausea and vomiting caused by neoadjuvant chemotherapy TAC/TEC. Choushi chemotherapy could effectively alleviate the side effects caused by neoadjuvant chemotherapy TAC/TEC, and this method is safe.
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