乳腺癌术后TEC与EC序贯T辅助化疗疗效和安全性临床分析

目的探讨TEC与EC序贯T方案在乳腺癌术后的临床疗效和安全性.方法入组60例乳腺癌术后化疗患者,按术后所应用的化疗方案划分为TEC组(25例)和EC序贯T组(35例),回顾性分析TEC方案与EC序贯T方案的术后化疗疗效、安全性.结果 TEC方案与EC序贯T方案一般情况如年龄、TMN分期、病理类型、肿瘤直径、分化程度、乳腺癌受体、淋巴转移、远处转移在组间未见显著差异;但EC序贯T方案的3 a无病生存率、总生存期显著高于TEC方案;TEC方案与EC序贯T方案在血液毒性方面、胃肠道反应、疲劳、黏膜炎等方面无显著差异,EC序贯T组的神经毒性显著高于TEC组(P0.001).结论乳腺癌术后EC序贯T方案可以延长乳腺癌患者术后的远期生存期,但神经毒性反应较严重,故在应用此方案的同时,应联用营养神经治疗,并密切观察神经毒性.

Clinical Analysis on Efficacy and Safety of Adjuvant Chemotherapy of TEC and EC Sequential T after Surgery in Patients with Breast Cancer

Objective To investigate the curative effect and safety between TEC scheme and EC sequential T scheme after breast cancer surgery. Method This study retrospectively included and analyzed 60 patients with breast cancer treated with postoperative chemotherapy. According to the postoperative chemotherapy scheme,the patients were divided into TEC group (25 cases) and EC sequential T group (35 cases) . The efficacy and safety of the chemotherapy schemes were compared between TEC group and EC sequential T group. Results No significant differences were detected in the general condition between TEC group and EC sequential T group, including age, TMN staging, pathological types, tumor size, differentiation, breast cancer receptor, lymphatic metastasis,distant metastasis. However,3 years survival rate and total survival of EC sequential T scheme group were significantly higher than those of TEC scheme group. The differences in blood toxicity, gastrointestinal reaction, fatigue,mucositis were not significant between the two groups,the occurrence of neurotoxicity in TEC group was observed more serious than that in EC sequential T group ( P<0 . 001 ) . Conclusion Compared to TEC solutions,EC sequential T scheme could extend the postoperative long term survival in patients with breast cancer. But the neurotoxicity in EC sequential T group was significantly more serious, so the application of EC sequential T scheme should be combined with nutritional neurotherapy and the neurotoxicity should be observed.