Neoadjuvant chemotherapy of breast cancer with pirarubicin versus epirubicin in combination with cyclophosphamide and docetaxel
Neoadjuvant chemotherapy of breast cancer with pirarubicin versus epirubicin in combination with cyclophosphamide and docetaxel
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DOI：
10.1007/s13277-015-3221-9
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发表时间：
2015-07-01
期刊：
影响因子：
--
通讯作者：
Zhang, Wen-Hai
中科院分区：
文献类型：
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作者：
Gu, Xi;Jia, Shi;Zhang, Wen-Hai
乳腺癌（BC）的治疗方法有手术、放疗和化疗。新辅助化疗（NACT）是许多癌症的一种新兴治疗选择，在主要治疗之前进行，以缩小肿瘤大小。NACT在各种BC情况下的疗效，如不可手术的肿瘤，边缘可切除的肿瘤和保乳手术，在文献中进行了广泛的辩论，结果仍然不清楚，并取决于各种因素，如癌症类型，疾病程度和化疗药物的具体组合。本研究旨在检查吡拉罗肽（THP）和表阿霉素（EPI）联合多西他赛和环磷酰胺在NACT环境中治疗BC的疗效、毒性和耐受性。将48例II期或III期乳腺癌患者随机分为THP组和EPI组。THP组患者在手术前接受了2-4个周期的DTC方案（多西他赛、THP、环磷酰胺）新辅助化疗，EPI组患者在手术前接受了2-4个周期的DEC方案（多西他赛、EPI、环磷酰胺）。比较两组不良反应发生率及治疗方案的疗效。采用Kaplan-Meier生存分析法评价5年无病生存期（DFS）和总生存期（OS）。THP组总有效率为83.3%，EPI组总有效率为79.2%，两组有效率差异无统计学意义。THP组的心脏毒性、骨髓抑制、恶心、呕吐发生率明显低于EPI组（均P
Breast cancers (BC) are treated with surgery, radiotherapy, and chemotherapy. Neoadjuvant chemotherapy (NACT) is an emerging treatment option in many cancers and is given before primary therapy to shrink tumor size. The efficacy of NACT in varied settings of BC, such as inoperable tumors, borderline resectable tumors, and breast-conserving surgery, has been debated extensively in literature, and the results remain unclear and depended on a wide variety of factors such as cancer type, disease extent, and the specific combination of chemotherapy drugs. This study was performed to examine the efficacy, toxicity, and tolerability of pirarubicin (THP) and epirubicin (EPI) in combination with docetaxel and cyclophosphamide in a NACT setting for BC. A total of 48 patients with stage II or III breast cancers were randomly divided into two groups: THP group and EPI group. The patients in THP group received 2-4 cycles of neoadjuvant chemotherapy with DTC regimen (docetaxel, THP, cyclophosphamide), while patients in the EPI group received 2-4 cycles of DEC regimen (docetaxel, EPI, cyclophosphamide) before surgery. The incidence of adverse reactions and the efficacy of the treatment regimen were compared between the two groups. Prognostic evaluation indexes were estimated by Kaplan-Meier survival analysis, including the 5-year disease-free survival (DFS) and overall survival (OS). The overall response rate in THP group was 83.3 %, and the EPI group showed a response rate of 79.2 %, with no statistically significant difference in response rate between the two groups. The incidence of cardiac toxicity, myelosuppression, nausea, and vomiting in the THP group was significantly lower than the EPI group (all P