关键词: 乳腺癌, 新辅助化疗, 外科保乳治疗, 预后

Abstract: Objective To investigate the effects of neoadjuvant chemotherapy(NAC)for locally advanced breast cancer(LABC).MethodsA total of 522 patients with LABC collected from January 1996 to December 2006 were enrolled and assigned randomly into NAC(T)group and control(C)group.Breast-conserving surgery(BCS)and total mastectomy(MT)were performed selectively for T group,after 4-6 cycles of NAC treatment that consist of FEC(5-Fluorouracil,Epirubicin,Cyclophosphamide)or TEC(Docetaxel,Epirubicin,Cyclophosphamide).MT was used only for C group.The rate of BCS and prognosis of LABC after NAC were analyzed.Results The response rate in T group was 89.19%(231/259),82.20%(217/264)of the patients became eligible for BCS after NAC among which 85 patients underwent BCS.After following-up for 36~166(median 67.4)months,there showed no significant difference between the patients in T and C group on the rates of recurrence,metastasis,overall survival and disease-free survival.The rates of overall survival and disease-free survival for complete clinical responders were 92.64%(63/68)and 88.23%(60/68)respectively,for incomplete clinical responders were 81.15%(155/191)and 73.82%(141/191)respectively,and differences were significant(P=0.026;P=0.017).Similarly,the rates of overall survival and disease-free survival in the pathological complete response(PCR)group were 97.14%(34/35)and 94.19%(33/35)respectively,while in the group that did not achieve PCR were 81.25%(182/224)and 75%(168/224)respectively,the differences between the two groups were significant(P=0.019;P=0.015).ConclusionsNeoadjuvant chemotherapy for patients with LABC can reduce the tumor size,improve the rate of breast conservation.To precisely assess the stage before treatment is crucial for judging the effects of NAC on prognosis of LABC.

Key words: Breast cancer, Neoadjuvant chemotherapy, Surgery, Breast-conserving therapy, Prognosis