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目的比较CEF-60、CEF-75与CEF-100方案对浸润性乳腺癌辅助化疗的预后及不良反应。方法 214例Ⅰ～Ⅲ期乳腺癌患者随机分为三组行术后辅助化疗,表柔比星小剂量组(CEF-60)71例,表柔比星常规剂量组(CEF-75)74例,表柔比星大剂量组(CEF-100)69例,21 d为一周期,行6～8周期化疗。对三组患者的无病生存状况、生存状况及毒副反应进行分析。结果 CEF-60组1年、3年、5年无病生存率及总生存率为85.92%、67.61%、57.75%及94.37%、85.92%、74.65%,均明显低于CEF-75及CEF-100组,其中CEF-60与CEF-75及CEF-100组间3年、5年无病生存率及5年总生存率差异有统计学意义(P=0.018,P=0.033,P=0.048),CEF-75与CEF-100组1年、3年、5年无病生存率及总生存率相当。CEF-100组Ⅲ～Ⅳ度白细胞下降发生率为49.28%,明显高于CEF-75及CEF-60组,三组间差异有统计学意义(P=0.013);CEF-100组Ⅲ～Ⅳ度消化道反应发生率为36.23%,明显高于CEF-75及CEF-60组,三组间差异具有统计学意义(P=0.017)。结论 CEF-75是预后较好、毒副作用较小的乳腺癌辅助化疗适用方案。
Objective To compare the prognosis and adverse reactions of adjuvant chemotherapy for invasive breast cancer with CEF-60, CEF-75 and CEF-100 regimens. Methods Two hundred and fourteen patients with stage I-III breast cancer were randomly divided into three groups: postoperative adjuvant chemotherapy, 71 patients with epirubicin low-dose group (CEF-60), and 71 patients with epirubicin conventional-dose group (CEF-75). , Epirubicin high-dose group (CEF-100) 69 cases, 21 days for a cycle of 6 to 8 cycles of chemotherapy. The disease-free survival, survival status, and toxic and side effects of the three groups of patients were analyzed. Results The disease-free survival rate and overall survival rate in CEF-60 group were 85.92%, 67.61%, 57.75%, 94.37%, 85.92% and 74.65%, which were significantly lower than those of CEF-75 and CEF-. In 100 groups, the 3-year 5-year disease-free survival rate and 5-year overall survival rate between CEF-60 and CEF-75 and CEF-100 groups were statistically significant (P=0.018, P=0.033, P=0.048). The disease-free survival rate and overall survival rate of CEF-75 and CEF-100 groups were equivalent to one year, three years and five years. The incidence of leukopenia at grades III to IV in the CEF-100 group was 49.28%, which was significantly higher than that in the CEF-75 and CEF-60 groups. The difference between the three groups was statistically significant (P=0.013); the CEF-100 group was III to IV degrees. The incidence of digestive tract reaction was 36.23%, which was significantly higher than that of CEF-75 and CEF-60 groups. The difference between the three groups was statistically significant (P=0.017). Conclusion CEF-75 is a suitable adjuvant chemotherapy for breast cancer with better prognosis and less side effects.