原发性乳腺癌新辅助化疗的紫杉醇单周与3周方案疗效比较
首发时间:2015-11-24
摘要:目的 比较蒽环续贯3周1次或每周1次紫杉醇的2种用药方案,在原发性乳腺癌新辅助化疗中的疗效。方法 213例病例符合纳入标准:1.北京肿瘤医院乳腺癌防治中心经空芯针穿刺活检(CNB)组织病理学确诊为浸润性乳腺癌,临床分期T1-3、N0-2、M0,年龄≤65岁;2.具有中重度复发转移风险;3.完成2轮CTFci4w方案(CTX500mg/m2,D1、D8 Q28D;THP35mg/m2,D1、D8 Q28D;5-Fu200mg/m2/day.ci D1-D28)新辅助化疗后,超声测量肿瘤最大垂直双径乘积较疗前减少不超过75%。全部研究对象随机分为A、B两组,A组109例患者(1例双侧乳腺癌),续贯4轮TPq3w方案(T175mg/m2, D1 Q21D;carboplatin AUC 6 mg/ml.min, D1 Q21D)新辅助化疗;B组104例患者(1例双侧乳腺癌),续贯4轮TPq1w方案(T60mg/m2, D1、D8、D15 Q21D;carboplatin AUC 6 mg/ml.min, D1 Q21D)新辅助化疗。依照Miller & Payne分级评价新辅助化疗后的疗效,比较两组病例的病理评效。结果B组较A组的病理评价显效率(Miller & Payne分级4、5级)更高(59.0% VS 45.5%, p= 0.046),无效率(Miller & Payne分级1、2级)更低(13.3% VS 28.2 %, p=0.007)。结论 在乳腺癌新辅助化疗中,蒽环类方案续贯紫杉醇单周用药方案较每3周1次的用药方案,病理反应率更高。
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Efficacy of weekly paclitaxel compared with 3 weeks schedule in primary chemotherapy of primary breast cancer
Abstract:In this paper, a single institute, prospective randomized trial was designed to compare the efficacy of the weekly paclitaxel to every-3-wk schedule in terms of pathological response. 213 histologically confirmed T1-3 N0-2M0 invasive breast cancer patients planed to receive adjuvant chemotherapy were eligible. After the completion of 2 cycles of CTFci ( CTX 500mg/m2 d1/d8, pirarubicin 35 mg/m2 d1/d8, 5-Fu 200 mg/m2.day.ci d1-28, every 4 weeks) primary chemotherapy, patients were randomized to received 4 cycles of TPq3w in 109patients (arm A: carboplatin AUC 6mg/ml.min day1, paclitaxel 175mg/m2 day1, every 3 weeks) or TPq1w in 104 patients (arm B: carboplatin AUC 6mg/ml.min day1, paclitaxel 60mg/m2 day1/8/15, every 3 weeks) before surgery. Pathological response of the primary tumor was evaluated by using Miller and Payne system. Arm A resulted more G1/G2 and less G5/G4 than arm B(28.1 % VS 13.3% , p=0.007)(45.5% VS 59.0%, p= 0.046). Conclusion: Weekly paclitaxel was more effective than 3 week schedule.
Keywords: Breast cancer primary chemotherapy paclitaxel efficacy
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No.4662261111093814****
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