Egwuonwu O A, Anyanwu S N C, Nwofor A M E
Department of Surgery, Federal Medical Centre, Owerri, Nigeria.
Niger J Clin Pract. 2012 Jul-Sep;15(3):265-9. doi: 10.4103/1119-3077.100618.
Breast cancer is the most frequent cancer among women in most parts of the world including Nigeria. Neoadjuvant chemotherapy has been demonstrated to be a helpful strategy in the context of locally advanced breast cancer.
The purpose of this study was to investigate some factors that may contribute to low rate of acceptance and adherence to neoadjuvant chemotherapy.
A 1-year prospective study of premenopausal women with locally advanced breast cancer recommended for neoadjuvant chemotherapy from June 2009 to May 2010.
Forty-four patients gave consent to be part of the study. The ages ranged from 26 to 51 years with a mean age of 42.1 years ± 7.7 years. Only 31 patients completed the four courses of NAC. Seventeen (38.6%) patients dropped out of treatment, before, during or after completing NAC. Ten of these defaulted due to inadequate funds to procure chemotherapy, three patients because they insisted on immediate mastectomy, and four of these patients refused surgery when they achieved complete clinical response, probably due to fear of mastectomy which is common among women in our environment. Twenty patients had dose deferment.
Lack of funds to procure chemotherapy and refusal of additional modality of treatment are the two major factors responsible for default of NAC and its goal in patients with LABC.
在包括尼日利亚在内的世界大部分地区，乳腺癌是女性中最常见的癌症。新辅助化疗已被证明是局部晚期乳腺癌治疗中的一种有效策略。
本研究旨在调查一些可能导致新辅助化疗接受率和依从率较低的因素。
对2009年6月至2010年5月期间被推荐接受新辅助化疗的绝经前局部晚期乳腺癌女性患者进行为期1年的前瞻性研究。
44名患者同意参与本研究。年龄范围为26至51岁，平均年龄为42.1岁±7.7岁。只有31名患者完成了四个疗程的新辅助化疗。17名（38.6%）患者在完成新辅助化疗之前、期间或之后退出治疗。其中10名患者因缺乏购买化疗药物的资金而违约，3名患者因坚持立即进行乳房切除术而违约，4名患者在获得完全临床缓解后拒绝手术，可能是因为害怕乳房切除术，这在我们当地的女性中很常见。20名患者出现剂量延迟。
缺乏购买化疗药物的资金以及拒绝接受额外的治疗方式是导致局部晚期乳腺癌患者新辅助化疗违约及其治疗目标无法实现的两个主要因素。
