| OBJECTIVE:To compare the clinical efficacy and side effects of XEC and TEC and FEC as the neoadjuvant chemotherapy regimens in the treatment of breast cancer, and explore the treatment of high efficience,low toxicity and high acceptance.METHORD:From January 2011 to December 2013,115 breast cancer patients who were diagnosed with invasive breast cancer by biopsy and were suited to surgical treatment, were treated with neoadjuvant chemotherapy in Breast Surgery of Tumor Hospital, Guangxi Zhuang Autonomous Region.They were assigned to XEC,TEC and TEC regimens randomly. XEC(xeloda+epirubicin+cyclophosphamide),TEC(docetaxel+epirubicin+Cyclop hosphamide),FEC(5-fluorouracil+epirubicin+Cyclophosphamide).Doses and uasage:xeloda 1000mg/m2,1000mg/m2, P.O, B.I.D,D1-14;Epirubicin 100mg/m2, IVGTT D1; Cyclophosphamide,500mg/m2, IVGTT D1; 5-Fu,500mg/m2, IVGTT, D1;Docetaxel,775mg/m2, IVGTT, D1.It were 21 days for a course of chemotherapy,and lasted four period of treatment.RESULT:After SPSS16.0 statistical software analysis:①in term of objective remission rate(ORR),XEC(32cases,93.94%), TEC(31cases,93.94%) and FEC(33cases,68.75%); According to the general comparison abour three groups, the difference was statistically significant.Comparing XEC to TEC, XEC to FEC and FEC toTEC in ORR, the outcomes were x2=0.000, P =1.000, and X2=5.985, P=0.014, and X2=7-914, P=0.005respectively.It indicated that XEC effect equaled to TEC, and both were higher than TEC. ②In the aspect of pCR, the number of XEC (6cases,18.18%)and TEC (4cases,12.12%)were more both than FEC (1case,2.08%). According to the general comparison abour three groups, the difference was no statistically significant(X2=1.443, P=0.486). In the aspects of CCR, PR, SD and PD, the outcomes were all P> 0.05. ③ In the total number of the decrease in tumor aspect, there were 32 cases,30 cases,42 cases belonged to XEC,TEC and FEC respectively. After a row x chi-square test list,X2=1.443, P=0.486, there was no statistically significant differences about three groups in the total number of the decrease in tumor. There were no statistically significant differences in different clinical stages and the decrease rate in tumor about three groups. ④According to the statistical test, the outcomes about efficient and molecular classification as follow:Luminal A, X2=0.040, P=0.980; Luminal B1, X2=1.264, P=0.532; Her-2(+), x2=0.442,P=0.496; TNBC(triple-negtive breast cancer)X2= 2.099, P=0.405; The efficient rate about Luminal B2 was 100%。There were no statistically significant differences in the efficient rate and molecular classification about three groups. ⑤Three groups of patients with axillary lymph node response rate as follow:according to the statistical test, the outcomes were N1, X2= 2.329,P=0.312;N2, X2= 1.678, P=0.432; and N3, X2= 5.506, P=0.064, there were no statistically significant differences in axillary lymph node response rate(X2= 1.503, P=0.472). ⑥About chemotherapy adverse reactions:The hand-foot syndrome with XEC regimens had the highest incidence,19 cases (55.88%), but joint and muscle pain, hair loss, phlebitis, Ⅲ-Ⅳ degree blood toxicity and Ⅲ-Ⅳ degree gastrointestinal reaction rate were the lowest in the three groups. There were statistically significant differences about joint and muscle pain, hair loss, hand-foot syndrome and Ⅲ-Ⅳ degree gastrointestinal reaction.CONCLUSION:The curative effect XEC regimens eaqualed to TEC regimens but higher than FEC regimens. The incidence rate of toxicities was lower and could be accepted by most patients, therfor, the XEC regimens can be considered as a breast cancer optimization scheme... |
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