TC、AC和TAC方案对Her-2阴性乳腺癌患者术后辅助治疗的临床疗效及安全性分析-现代医学

TC、AC和TAC方案对Her-2阴性乳腺癌患者术后辅助治疗的临床疗效及安全性分析

单位：1. 南京医科大学附属淮安第一医院肿瘤内科, 江苏淮安 223000;
2. 南京医科大学附属淮安第一医院外科, 江苏淮安 223000

分类号：R737.9

出版年·卷·期（页码）：2023·51·第十一期（1520-1525）

摘要：

目的：探讨多西他赛联合环磷酰胺(TC)、多柔比星联合环磷酰胺(AC)和多西他赛联合多柔比星以及环磷酰胺的方案(TAC)不同化疗方案对 Her-2 阴性乳腺癌患者术后辅助治疗的临床疗效和安全性。方法：选择乳腺癌术后Her-2 阴性乳腺癌患者90例，根据化疗方案分成TC组、AC组、TAC组，每组30例。通过比较化疗前后肿瘤指标、不良反应、复发转移及生存差异，评价化疗方案的疗效和安全性。结果：与化疗前相比，3种方案化疗后血清肿瘤指标水平均显著降低。不良反应方面，TAC组患者中性粒细胞计数下降并显著低于TC组(P=0.003)和AC组(P=0.02)。TAC组化疗后5年无复发生存率为86.1%，显著高于TC组(63.3%，P=0.045)和AC组(60.0%，P=0.024)。3种方案化疗的5年总生存率差异无统计学意义。结论：采用TAC化疗方案治疗Her-2 阴性乳腺癌术后患者总体效果优于TC及AC方案，但易导致中性粒细胞减少。

Objective: To analyze the clinical efficacy and safety of docetaxel and cyclophosphamide(TC), doxorubicin and cyclophosphamide(AC) and docetaxel, doxorubicin and cyclophosphamide(TAC) postoperative adjuvant chemotherapy regimens in the treatment of patients with Her-2 negative breast cancer. Methods: Ninety postoperative patients diagnosed with Her-2 negative breast cancer were recruited and divided into TC group, AC group and TAC group with 30 cases in each group. The clinical efficacy and safety of the three chemotherapy regimens were evaluated by comparing the differences in serum tumor markers, side effects, recurrence and metastasis and survival before and after chemotherapy. Results: After chemotherapy, the levels of tumor markers CA-125 and CA15-3 were significantly lower in TAC group than those in TC and AC groups. In terms of side effects, the rate of neutropenia was significantly decreased in TAC group than that in TC group(P=0.003) and AC group(P=0.02). The 5-year recurrence-free survival rate in the TAC group was 86.1%, which was significantly higher than that in TC group(63.3%, P=0.045) and AC group(60.0%, P=0.024). However, there was no statistical difference in 5-year survival rate among the three groups. Conclusion: The clinical efficacy of TAC chemotherapy regimen is better than that of TC regimen and AC regimen in the treatment of postoperative patients with Her-2 negative breast cancer. However, it is suggested that TAC regimen is prone to result in neutropenia.

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