Clinical Observation Of Chemotherapy Combine With Endocrine Therapy Efficacy In The Treatment Of Patients With Breast Cancer

Background and Objective: Breast cancer is a systemic disease, even in the early stage of breast cancer, it is possible there is a tiny metastasis. Surgery and radiotherapy for localized lesions and effective, while the systemic micro-metastases or organ metastasis invalid, chemotherapy was able to compensate for this defect, therefore, apart from 0, or in patients with stageⅠoutside, almost all patients require medical treatment during a given period. Medical treatment of breast cancer can be effective in reducing the recurrence rate in patients with early stage and mortality, metastatic patients can shrink tumors, improve symptoms, improve quality of life and prolong life. Medical treatment of breast cancer has become an important component of comprehensive treatment. In order to explore more effective treatment for breast cancer patients ,which the toxicity is low, were more likely to endure and easy method of observed and compared to chemotherapy alone and chemotherapy combined with endocrine therapy short-term efficacy and toxicity, In order to explore a more rational integrated treatment programs provide clinical data.Materials and Methods: 43 patients after radical mastectomy of our Section randomly into the group in March 2008 ~ December 2009.Those patients were divided into two groups, A group, chemotherapy group (21 cases); B group, chemotherapy combined with endocrine therapy group (22 cases). Two groups of patients were female, aged 36 to 65 years old, with a median age of 49 years. Into the group of patients with pathological types, clinical stage, immunohistochemistry, receptor (ER, PR) detected no significant difference in such indicators as,and both should be endocrine therapy. Two chemotherapy regimens are FAC program(5-Fu 500mg /㎡, intravenous, the first 1,8 days; ADM 50 mg /㎡, intravenous, day 1; CTX 500 mg /㎡, intravenous, day 1) 21 days for a cycle and six cycles is better. Endocrine therapy with oral tamoxifen (10-20mg / times, 2 times / day), Observed indicators and efficacy of evaluation criteria: tumor markers: each patient before treatment and medication in the subsequent four-cycle test CEA, CA15 3, CA125 once. Methods: Fasting venous blood collected 2ml, serum obtained after centrifugation, -20℃cryopreservation, applied bio-chip detector (Shanghai a few Kang Biotechnology Co., Ltd. HD-2001A), a variety of tumor marker protein chip kit (Shanghai a few Kang Bio-Technology Co., Ltd.), the steps carried out according to kit instructions. Complete the results statistically. Normal reference values: CEA serum <5 ng / ml, CA125 serum <35U/ml, CA153 serum <35U/ml. Cancer patients quality of life score standards Karnofsky (Karnofsky, KPS, Bai Fenfa) functional status assessment criteria: Normal, asymptomatic, and signs (100 points); able to carry out normal activities, with mild symptoms and signs (90 points); reluctant to carry out normal activities, there are some symptoms or signs (80 points); life to take care of themselves, but can not maintain normal life and work (70 points); life to the majority of self-care, but occasionally need help (60 points); often people need to care (50 points); life can not take care of themselves in need of special care and assistance (40 points); life seriously can not take care of themselves (30 points); critically ill, requiring hospitalization and active supportive care (20 points); critically close to death (10 points); death (0 points). Efficacy: Comprehensive Evaluation of treatment after 4 cycles, In this article, depending on the circumstances, self-efficacy evaluation criteria provides as follows: 1. Stable condition: ipsilateral and contralateral breast lymph nodes, underarm lymph nodes and supraclavicular lymph nodes are negative, imaging studies revealed no metastatic lesions in other organs that have a tumor marker for detection of the three joint values are maintained within the normal range, KPS score greater than 80 points; 2. Disease progression: the above checks there is a change of one or more indicators, including tumor markers check one or more of the value of increased (higher than normal, or pre-treatment levels), KPS score of less than 80 minutes. Response rates is in a stable condition cases / total number of cases×100%. Toxicity: All checks once a routine blood test, liver function, kidney function and ECG in a weekly period of chemotherapy before and after chemotherapy,4 cycles of chemotherapy, gynecological ultrasound examinations, the endometrium, chemotherapy every 3 to 5 days during the review routine blood test 1 times, and to keep records of all adverse drug reactions. Toxicity according to WHO classification criteria, sub 0 ~Ⅳdegrees. Results: Chemotherapy alone group (A group) 21, all of whom completed the six cycles of chemotherapy, a total of 126 cycles; Chemotherapy combined with endocrine therapy group (B group), 22, of whom five have completed the six cycles of chemotherapy, 10 have asked to disable the ATM and then to complete two cycles of treatment, and then continue to complete the six cycles of chemotherapy, five were re-completed four-cycle after treatment required to disable ATM, and then continue to complete the six cycles of chemotherapy, two were treated and then terminated after the completion of four-cycle treatment, a total of 128 cycles. The conduct of this clinical observation in patients completed four cycles of treatment. Comparison of short-term effect: A group of 16 patients in stable condition, five cases of disease progress, efficiency of 76.2%; B group in a stable condition in 18 cases, 4 cases of disease progress, efficiency of 81.8%. Based on the above statistics: A group and B group compared with no significant difference in efficiency (P> 0.05). A group and B group toxicity mainly manifested in the decline in white blood cells, platelets decreased, hemoglobin decreased, nausea and vomiting, diarrhea, bone pain, hair loss, thickening of the endometrium, A group and B group compared to, B group of bone pain, the high incidence of endometrial thickening, and the difference was statistically significant.Conclusion: 1. Chemotherapy alone and chemotherapy combined with endocrine therapy group in the near future have a similar effect to benefit;2. Chemotherapy in patients with endocrine treatment group patients than in chemotherapy group had more adverse events occurred;3. Endocrine therapy conducted after chemotherapy is a better choice, because it would significantly reduce the patient's adverse reaction.