Liu Yang, Xu Zhaoguo, Zhang Zhenyong, Wen Guangfu, Sun Jiaxing, Han Feng
Department of Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110000, P.R. China.
Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110000, P.R. China.
Oncol Lett. 2019 Jan;17(1):907-912. doi: 10.3892/ol.2018.9658. Epub 2018 Nov 1.
Efficacy and safety of paclitaxel/docetaxel + epirubicin (TE), paclitaxel/docetaxel + epirubicin + cytoxan (TEC) and intensive paclitaxel (IP) neoadjuvant chemotherapy (NCT) were compared for the treatment of breast cancer. The clinical data of 326 patients with stage II-III unilateral primary breast cancer treated in Shengjing Hospital of China Medical University from January 2012 to April 2016 were retrospectively analyzed. All patients received NCT for 4 cycles, including 115 cases of TE group, 109 cases of TEC group, and 102 cases of paclitaxel weekly group. The clinical efficacy was evaluated and complete response (CR) + partial response (PR) indicated clinically effective. The pathological effect was evaluated and the grade III+IV+V indicated pathologically effective. The rates of clinical efficacy and pathological CR (pCR) were compared, and the incidence of adverse reactions was also observed. The effects of different molecular typing on clinical efficacy and pCR were compared. Our results showed that the clinical effective rates in TE, TEC and IP groups were 80.9, 89.0 and 77.5%, respectively, and there were no statistically significant differences (P=0.074). The pCR rates in the three groups were 9.57, 8.26 and 5.88%, respectively, and the differences were not statistically significant (P=0.602). The incidence rate of neutropenia was statistically different among the three groups of patients (P<0.001), which was the highest in TEC group and the lowest in IP group. There were no statistically significant differences in the incidence rates of adverse reactions (P>0.05). Estrogen receptor (ER)-negative, progesterone receptor (PR)-negative and human epidermal growth factor receptor-2 (HER-2)-positive states were significantly correlated with the high clinical effective rate and high pCR rate (P<0.05). In conclusion, IP has the lowest incidence rate of neutropenia. Additionally, ER-negative, PR-negative and HER-2-positive states are significantly correlated with the high clinical effective rate and high pCR rate.
比较了紫杉醇/多西他赛+表柔比星（TE）、紫杉醇/多西他赛+表柔比星+环磷酰胺（TEC）和密集紫杉醇（IP）新辅助化疗（NCT）治疗乳腺癌的疗效和安全性。回顾性分析了2012年1月至2016年4月在中国医科大学附属盛京医院接受治疗的326例II-III期单侧原发性乳腺癌患者的临床资料。所有患者均接受4周期NCT，其中TE组115例，TEC组109例，紫杉醇每周方案组102例。评估临床疗效，完全缓解（CR）+部分缓解（PR）表示临床有效。评估病理疗效，III+IV+V级表示病理有效。比较临床疗效和病理CR（pCR）率，并观察不良反应发生率。比较不同分子分型对临床疗效和pCR的影响。结果显示，TE、TEC和IP组的临床有效率分别为80.9%、89.0%和77.5%，差异无统计学意义（P=0.074）。三组的pCR率分别为9.57%、8.26%和5.88%，差异无统计学意义（P=0.602）。三组患者中性粒细胞减少的发生率差异有统计学意义（P<0.001），TEC组最高，IP组最低。不良反应发生率差异无统计学意义（P>0.05）。雌激素受体（ER）阴性、孕激素受体（PR）阴性和人表皮生长因子受体2（HER-2）阳性状态与高临床有效率和高pCR率显著相关（P<0.05）。总之，IP中性粒细胞减少的发生率最低。此外，ER阴性、PR阴性和HER-2阳性状态与高临床有效率和高pCR率显著相关。
