表柔比星方案辅助化疗治疗乳腺癌的剂量选择
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摘要
目的研究分析不同剂量表柔比星化疗方案对乳腺癌患者的影响。方法方便选取2012年1月—2017年1月该院收治的乳腺癌患者252例纳为研究对象,随机分为A组(126例)与B组(126例)。予A组以大剂量表柔比星,B组以小剂量表柔比星,余予相同剂量多西他赛、环磷酰胺。经3个疗程化疗后,统计分析两组患者近期症状缓解情况、生存率、不良反应以及各临床因素下不同剂量表柔比星化疗方案对乳腺癌患者的影响。结果经3个疗程的化疗后两组患者中病情缓解、病情稳定、病情进展的比例差异无统计学意义(P>0.05),两组1、3、5年生存率比较,差异无统计学意义(P>0.05)。而A组的血液系统不良反应、消化系统不良反应高于B组[(15.9%vs 9.5%)(14.3%vs 8.7%)],差异有统计学意义(χ2=12.43,10.98,P<0.05)。A组中三阴性及ER/PR阴性乳腺癌患者的平均无病生存期明显高于B组[(59.56个月vs 41.38个月)(58.21个月vs 40.35个月)],差异有统计学意义(t=15.32,15.37,P<0.05)。结论表柔比星剂量的大小对乳腺癌患者的近期缓解及5年生存率无明显影响,大剂量表柔比星化疗方案的血液系统不良反应、消化系统不良反应大于小剂量表柔比星,而大剂量表柔比星对三阴性及ER/PR阴性乳腺癌患者有显著的疗效。
Objective To study the effects of different doses of doxorubicin chemotherapy on breast cancer patients. Methods A total of 252 breast cancer patients admitted to the hospital from January 2012 to January 2017 were convenient divided into group A(126 cases) and group B(126 cases). Group A was given a large dose of epirubicin, group B was given a small dose of epirubicin, and the same dose of docetaxel or cyclophosphamide was given. After 3 courses of chemotherapy,the short-term symptom relief, survival rate, toxicity and side effects of different groups of patients and the effects of different doses of epirubicin chemotherapy on breast cancer patients were analyzed statistically. Results After 3 courses of chemotherapy, there was no significant difference in the degree of remission, stable disease, and progression of the disease between the two groups(P>0.05). There was no significant difference in the 1-, 3-, and 5-year survival rates between the two groups(P>0.05). The side effects of the blood system and the side effects of the digestive system in group A were higher than those in group B [(15.9% vs 9.5%)(14.3% vs 8.7%)], which was statistically significant(χ2=12.43, 10.98, P<0.05). The mean disease-free survival of patients with triple-negative and ER/PR-negative breast cancer in group A was significantly higher than that in group B [(59.56 months vs. 41.38 months)(58.21 months vs. 40.35 months)], with statistical significance(t=15.32, 15.37, P<0.05). Conclusion The dose of epirubicin has no significant effect on the recent remission and 5-year survival rate of breast cancer patients. The high-dose epirubicin chemotherapy regimen has higher blood system side effects and digestive system side effects than small doses of doxorubicin. However, high-dose epirubicin has a significant effect on patients with triple-negative and ER/PR-negative breast cancer.
Objective To study the effects of different doses of doxorubicin chemotherapy on breast cancer patients. Methods A total of 252 breast cancer patients admitted to the hospital from January 2012 to January 2017 were convenient divided into group A(126 cases) and group B(126 cases). Group A was given a large dose of epirubicin, group B was given a small dose of epirubicin, and the same dose of docetaxel or cyclophosphamide was given. After 3 courses of chemotherapy,the short-term symptom relief, survival rate, toxicity and side effects of different groups of patients and the effects of different doses of epirubicin chemotherapy on breast cancer patients were analyzed statistically. Results After 3 courses of chemotherapy, there was no significant difference in the degree of remission, stable disease, and progression of the disease between the two groups(P>0.05). There was no significant difference in the 1-, 3-, and 5-year survival rates between the two groups(P>0.05). The side effects of the blood system and the side effects of the digestive system in group A were higher than those in group B [(15.9% vs 9.5%)(14.3% vs 8.7%)], which was statistically significant(χ2=12.43, 10.98, P<0.05). The mean disease-free survival of patients with triple-negative and ER/PR-negative breast cancer in group A was significantly higher than that in group B [(59.56 months vs. 41.38 months)(58.21 months vs. 40.35 months)], with statistical significance(t=15.32, 15.37, P<0.05). Conclusion The dose of epirubicin has no significant effect on the recent remission and 5-year survival rate of breast cancer patients. The high-dose epirubicin chemotherapy regimen has higher blood system side effects and digestive system side effects than small doses of doxorubicin. However, high-dose epirubicin has a significant effect on patients with triple-negative and ER/PR-negative breast cancer.
引文
[1]李光,刘洪霞,刘军.不同剂量表柔比星联合新辅助化疗治疗三阴性乳腺癌的疗效和毒副反应[J].河北医药,2017,14(9):1387-1389,1392.
[2]武惠丽,李毅.多西他赛与表柔比星联合或序贯化疗治疗局部晚期乳腺癌的临床疗效研究[J].河北医学,2017,10(4):639-642.
[3]李建梅,孙静宜,周桂萍,等.不同化疗方案治疗转移性乳腺癌的临床效果比较[J].解放军医药杂志,2017,21(4):9-11.
[4]李新,尚学琴.高剂量表柔比星在乳腺癌化疗中的不良反应与防治[J].云南医药,2017,15(6):631-634.
[5] Puhalla S,Brufsky A.Treatment of HER2-positive breast cancer:looking backwards briefly[J].Lancet Oncol,2017,14(13):1250-1251.
[6]尚学琴,段玉印,王继营,等.高剂量表柔比星TEC方案新辅助化疗三阴乳腺癌的近期疗效及耐受性[J].昆明医科大学学报,2016,13(6):93-96.
[7]吴金伟.高危乳腺癌术后辅助剂量密集化疗的网络meta分析[D].南宁:广西医科大学,2015.
[8]李新,刘薇,牛冰.小剂量卡维地洛联合坎地沙坦对乳腺癌蒽环类药物心脏毒性的预防价值[J].实用癌症杂志,2016,10(2):256-259.
[9]李津凯.CEF-100方案与CEF-60方案对乳腺癌辅助化疗临床耐受性的随机对照研究[J].现代中西医结合杂志,2016,20(3):271-273.
[10]胡爱萍.不同剂量表柔比星紫杉醇新辅助化疗治疗三阴性乳腺癌的疗效和毒副反应比较[J].现代诊断与治疗,2017,13(24):5564-5565.
[2]武惠丽,李毅.多西他赛与表柔比星联合或序贯化疗治疗局部晚期乳腺癌的临床疗效研究[J].河北医学,2017,10(4):639-642.
[3]李建梅,孙静宜,周桂萍,等.不同化疗方案治疗转移性乳腺癌的临床效果比较[J].解放军医药杂志,2017,21(4):9-11.
[4]李新,尚学琴.高剂量表柔比星在乳腺癌化疗中的不良反应与防治[J].云南医药,2017,15(6):631-634.
[5] Puhalla S,Brufsky A.Treatment of HER2-positive breast cancer:looking backwards briefly[J].Lancet Oncol,2017,14(13):1250-1251.
[6]尚学琴,段玉印,王继营,等.高剂量表柔比星TEC方案新辅助化疗三阴乳腺癌的近期疗效及耐受性[J].昆明医科大学学报,2016,13(6):93-96.
[7]吴金伟.高危乳腺癌术后辅助剂量密集化疗的网络meta分析[D].南宁:广西医科大学,2015.
[8]李新,刘薇,牛冰.小剂量卡维地洛联合坎地沙坦对乳腺癌蒽环类药物心脏毒性的预防价值[J].实用癌症杂志,2016,10(2):256-259.
[9]李津凯.CEF-100方案与CEF-60方案对乳腺癌辅助化疗临床耐受性的随机对照研究[J].现代中西医结合杂志,2016,20(3):271-273.
[10]胡爱萍.不同剂量表柔比星紫杉醇新辅助化疗治疗三阴性乳腺癌的疗效和毒副反应比较[J].现代诊断与治疗,2017,13(24):5564-5565.