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目的 探讨临床Ⅰ、Ⅱ期乳腺癌术前短程化疗的意义。方法 12 2例临床Ⅰ、Ⅱ期乳腺癌术前用CEF方案化疗 1疗程 ,化疗后 3～ 5d手术。结果 部分缓解 2 1例 (占 17 2 %) ,轻度缓解 76例 (占 6 2 3%) ,无变化 2 5例(占 2 0 5 %) ,无临床进展病例。术前可扪及腋窝肿大淋巴结 42例 ,化疗后 30例见淋巴结明显缩小或消失。病理组织学观察 75例镜下见肿瘤细胞有小点片状坏死。 10 6例按计划手术 ;16例因白细胞降低等化疗反应推迟手术。全组随访 1～ 6年 ,无局部复发病例 ;6例在随访期间 1～ 3年内发现骨转移 ,经放疗和化疗控制 ;仅 1例同时有骨转移和肺转移者于术后 4年死亡 ;余均健在。结论 可手术乳腺癌的术前短程化疗可观察到肿瘤缩小等治疗效果 ,为术后化疗提供指导。并可能减少术中血行转移和提高疗效。
Objective To investigate the clinical significance of preoperative short-course chemotherapy for stage Ⅰ and Ⅱ breast cancer. Methods 12 cases of clinical stage Ⅰ, Ⅱ breast cancer preoperative CEF regimen of a course of chemotherapy, chemotherapy 3 to 5 days after surgery. The results were partially alleviated in 21 cases (17.2%), mild relief in 76 cases (62.3%), no change in 25 cases (20%), and no clinical progression. Preoperative palpable axillary lymph nodes in 42 cases, 30 cases of lymph nodes after chemotherapy significantly reduced or disappeared. Histopathological observation of 75 cases of microscopic tumor cells see the small piece of necrosis. 10 6 cases were operated on according to the schedule; 16 cases were delayed because of leukopenia and other chemotherapy reactions. All cases were followed up for 1 to 6 years without any local recurrence. Six cases were found to have bone metastases within 1 to 3 years after follow-up and were controlled by radiotherapy and chemotherapy. Only 1 case died of bone metastasis and lung metastasis 4 years after the operation. I am still alive. Conclusion Preoperative short-course chemotherapy for operable breast cancer can be observed shrinkage and other therapeutic effect, to provide guidance for postoperative chemotherapy. And may reduce intraoperative blood metastasis and improve efficacy.