Comparative Study Of Preoprative Interventional Chemotherapy And Whole Body Chemotherapy In Patients With Locally Advanced Breast Cancer

Objective To compare the efficacy of preoperative regional interventional chemotherapy (IC) and whole body chemotherapy (WC) in the patients with locally advanced breast cancer.Methods Seventy-two patients with clinically diagnosed locally advanced breast cancer( Ⅱb,Ⅲa,Ⅲb stages) were randomly divided into two groups which included 34 cases of IC and 38 cases of WC. The chemotherapeutic (CD) used in the both groups were adriamycin (ADM),5-fluorouracil (5-FU),and cyclophosphamide (CPA).The doses of CD in each and every course of treatment were 40 mg/m~2 for ADM,400 mg/m~2 for CPA,and 500 mg/m~2 for 5-FU.In interventional chemotherapy groups (ICG) intra-arterial infusion chemotherapy was performed by using seldinger's technigue,i.e.following percutaneous femoral artery puncture the catheter was send to subclavian arteries in affected side and then superselectively inserted into tumor feeding arteries those were demonstrated angiography,then varied CD dissolved spectively in 50ml of physiological saline were slowly injected into the target arterial. After the completion of interventional procedure, the puncture region was pressurized and bundled. The intervals between each and every course of treatment depended on diminished degree of the tumor, mean one month was taken as a course of treatment. In whole body chemotherapy groups (WCG),CDs were once intravenously administratd, three weeks were taken as a course of treatment, in general, therapeutic duration was 2 to 4 course of treatment. The observing indices in this study included: a) prechemotherapeulic, postchemotherapeutic, preoperative,and postoperative changes of tumor size (two maximal vertical diameters product of tumor); b) invasive extent of surrouding tissue; c) interval time between chemotherapy and operation (day); d) adverse reaction of CD such as the presence or the absence of gastrointestinal tract reaction or baldness, bone marrow inhibition (WBC number < 4.0 ×10~9/L); and e) the necrotic status of tumorous tissue on postoperative patholongic sections.