摘要
目的:比较不同剂量表柔比星方案辅助化疗治疗乳腺癌的近期疗效及不良反应.方法:选取2005-01-01-2008-06-30大连医科大学附属第二医院采用含表柔比星方案辅助化疗的309例Ⅰ～Ⅲ期乳腺癌患者,分为表柔比星大剂量(100mg/m2)组和小剂量(75 mg/m2)组,回顾性分析比较两组间1、3、5年无病生存率(disease-free survival,DFS)、总生存率(overall survival,OS)及不良反应,并采用Cox回归分析预后影响因素.Log-rank法比较两组生存差异,并分层分析筛选出从大剂量中获益的人群.结果:大剂量组与小剂量组1年DFS分别为95.05％和96.15％,3年DFS分别为84.16％和80.77％,5年DFS分别为77.23％和74.52％;1年OS分别为97.03％和98.08％,3年OS分别为93.07％和90.87％,5年OS分别为87.13％和83.17％.大剂量组疗效略高于小剂量组,但两组DFS(P=0.543)及OS(P=0.396)差异无统计学意义.Cox风险比例模型分析再次验证化疗方案中表柔比星的剂量不是影响DFS及OS的重要因素.分层分析结果显示,ER/PR阴性表达(P=0.026)及三阴性乳腺癌(P=0.044)患者大剂量组平均DFS高于小剂量组,差异有统计学意义.大剂量组的胃肠道毒性(P=0.042)及血液毒性(P=0.010)均较小剂量组大,差异有统计学意义.结论:表柔比星大、小不同剂量组之间近期疗效差异无统计学意义;仅ER和PR表达阴性及三阴性乳腺癌的患者能从大剂量表柔比星辅助化疗中获益.大剂量组化疗胃肠道毒性和血液毒性明显大于小剂量组.
Abstract
OBJECTIVE:To compare the short-term effect and side effects between chemotherapy regimens with different dose of epirubicin.METHODS:Totally 309 stage Ⅰ to Ⅲ breast cancer patients were divided in to E100 regimen group and E75 regimen group,from 2005-01-01 to 2008-06-31 in Second Hospital of Dalian Medical University.The 1-,3-and 5-year disease-free survival (DFS),and overall survival (OS) as well as side effects were analyzed between the two groups.Those who can benefit from the E100 regimen were selected to analyze the independent prognostic factors with Cox regression.RESULTS:The 1-,3-,5-year DFS and OS of E100 regimen were 95.05％,84.16％,77.23％ and 97.03％,93.07％,87.13％,the E75 regimen were 96.15％,80.77％,74.52％ and 98.08％,90.87％,83.17％.The E100 regimen had better effect,but DFS and OS of the two groups had no statistical difference(P =0.543,P =0.396).Multivariate prognostic analysis showed that the different dose were not the independent factor affecting the prognosis of breast cancer patients in both DFS and OS.DFS on average in E100 regimen group was more than that in E75 regimen in TNBC group and ER/PR negative group,which had statistical difference(P=0.026,P=0.044).The E100 regimen group had more alimentary tract toxicity and hematologic toxicity,with statistical significance(P =0.042,P =0.010).CONCLUSIONS:The short-term effect between E100 and E75 regimen are the same.Only the TNBC group and ER/PR negative group could benefit from the E100 regimen.E100 regimen group had more alimentary tract and hematologic toxicit.
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NSTL
维普
万方数据