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目的探讨新辅助化疗对老年乳腺癌患者的临床疗效及预后情况。方法选取2009年1月至2011年1月河南省郑州市中医院收治的90例老年乳腺癌患者,对患者的临床资料进行回顾性分析,采用Cox回归模型探讨影响患者预后的相关因素。结果所有患者治疗后总有效率为67.8%,病理完全缓解率为18.9%,且单因素分析,肿瘤直径能够影响老年乳腺癌患者新辅助化疗的病理完全缓解率。患者5年无瘤生存率为71.1%,总生存率为77.8%。单因素分析,患者5年无瘤生存率与肿瘤TNM分期、合并疾病、病理类型、孕激素受体、新辅助化疗方案以及病理完全缓解有关,差异均有统计学意义(均P<0.05),5年总生存率与合并疾病及雌、孕激素受体有关,差异均有统计学意义(均P<0.05)。多因素分析,激素受体是影响无瘤生存率的独立危险因素,合并疾病是影响总生存率的独立危险因素,差异均有统计学意义(P<0.05)。结论新辅助化疗治疗老年乳腺癌,能取得较好的临床疗效,明显提升患者总生存率。老年乳腺癌患者的预后受多种因素的影响。
Objective To investigate the clinical effect and prognosis of neoadjuvant chemotherapy in elderly patients with breast cancer. Methods Ninety elderly patients with breast cancer who were admitted to Zhengzhou Hospital of Traditional Chinese Medicine from January 2009 to January 2011 were retrospectively analyzed. Cox regression model was used to explore the factors influencing the prognosis of patients. Results After treatment, the total effective rate was 67.8% in all patients and the pathological complete remission rate was 18.9%. Univariate analysis showed that the tumor diameter could affect the rate of complete remission of neoadjuvant chemotherapy in elderly patients with breast cancer. The 5-year disease-free survival rate was 71.1% and the overall survival rate was 77.8%. Univariate analysis showed that 5-year disease-free survival rate was related to tumor TNM stage, combined disease, pathological type, progesterone receptor, neoadjuvant chemotherapy regimen and pathologic complete remission (all P <0.05) The 5-year overall survival rate was associated with combined disease and estrogen and progesterone receptors, with significant differences (all P <0.05). Multivariate analysis showed that hormone receptor was an independent risk factor influencing tumor-free survival rate. Combined disease was an independent risk factor influencing overall survival rate (P <0.05). Conclusion Neoadjuvant chemotherapy for elderly patients with breast cancer can achieve better clinical efficacy and significantly improve the overall survival rate. The prognosis of elderly patients with breast cancer is affected by many factors.