全身化疗联合肝动脉栓塞化疗治疗乳腺癌术后肝转移的临床疗效观察.pdf

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饶智国,等全身化疗联合肝动脉栓塞化疗治疗乳腺癌术后肝转移的临床疔效观察
全身化疗联合肝动脉栓塞化疗治疗乳腺癌术后肝转移的临床疗效观察
饶智国,高建飞,章必成,张亚飞,董兰兰,刘健,余丽芳
Clinical observation of breast cancer liver metastasis after mastectomy by combined treat
ment of transarterial chemoembolization(TACE )and systemic chemotherapy
Rao Zhiguo, Gao Jianfei, Zhang Bicheng, Zhang Yafei, Dong Lanlan, Liu Jian, Yu Lifang
Department of cology, Wuhan General Hospital, Guan how Command of PLA, Hubei Wuhan 430070, China
Abstract)Objective: To investigate the efficacy and toxicity of combined treatment of transarterial chemoemboli
zation (TACE ) and systemic chemotherapy for breast cancer liver metastasis after mastectomy. Methods: All 62 cases
of metastatic breast cancer were treated by systemic chemotherapy or combined systemic chemotherapy with TACE
Results: Of the 62 patients, the overall response rate(OR) was 51. 6%, including 37.0% in chemotherapy group, and
52.9% in systemic chemotherapy plus TACE group. Combined treatment group was better than that of the systemic
chemotherapy(P <0.05 The total median overall survival (mos)was 17 months and of which 15 months in system-
ic chemotherapy group and 2 months in systemic chemotherapy plus TACE group. There was significant diference be-
tween systemic chemotherapy group and systemic chemotherapy plus TACE group(P<0.05). The main treatment
related adverse events were bone marrow inhibition and enterogastric reaction. Conclusion: Combined treatment of
systemic chemotherapy and TACE is an effective and feasible therapy for breast cancer liver metastasis after mastecto-
my. The toxicity profile was acceptable
Key words)breast cancer; systemic chemotherapy: transarterial chemoembolization; liver metastasis
Modern Oncology2013,21(09):1994-1996
【摘要】目的:探讨全身化疗联合肝动脉栓塞化疗治疗乳腺癌术后肝转移的临床疗效及毒副反应。方法:对
62例乳腺癌患者分别采用全身化疗或全身化疗联合肝动脉栓塞化疗,比较其疗效。结果:62例患者中总有效
率(OR)为51.6%,其中,全身化疗组的客观有效率(RR)为37.0%,全身化疗加肝动脉栓塞化疗的患者客观
有效率(RR)为62.9%,联合治疗组的疗效明显好于单纯化疗组(P<0.05)。总中位生存期为17个月,其中,
全身化疗组中位生存期为15个月,全身化疗加TACE组中位生存期为22个月,两者的生存期有显著差异(P
<0.05)。主要毒副反应为骨髓抑制和胃肠道反应。结论:全身化疗联合肝动脉栓塞化疗治疗乳腺癌肝转移
疗效显著,毒副作用小,可以作为乳腺癌肝转移综合治疗中的主要治疗手段。
【关键词】乳腺癌;化学疗法;肝动脉栓塞化疗;肝转移
中图分类号)R737.9
文献标识码】A
DOI:10.3969/j.issn.1672-4992.2013.09.26
文章编号】1672-4992-(2013)09-1994-03
乳腺癌是全世界女性最常见的痛症和主要的癌症死亡
为此,我们分别采用全身化疗和全身化疗联合肝动脉栓
原因,2008年全世界新诊断的女性乳腺癌患者有1383500塞化疗(TACE)的方法治疗乳腺癌肝转移患者,比较两种方
例,占新诊断癌症病例的23%,死亡458400人,占全部癌症疰法对患者疗效的影响。
死亡人数的14%。乳腺癌常常转移至骨、肺和/或肝,大1资料与方法
约40%-50%的转移性乳腺癌患者在她们的疾病发展过程1.1一般资料
中会发生肝转移,这些患者往往预后较差门。全身化疗是乳
2004年6月至2012年2月我院住院病人,2例均为女
腺癌肝转移的标准治疗方法,尽管近年来出现了一些新的化性,平均年岭48.1岁(31-72岁),KPS评分≥70分。本组
疗药物和化疗方法,但疗效仍不尽人意。如何提高乳腺癌肝病人原发灶均经乳腺改良根治术或根治术。所有患者均经
转移的治疗效果、延长患者的生存期,是目前临床研究中亟病理(WHO标准)学检査证实,其中浸润性导管癌54例,浸
需解决的问题
润性小叶癌6例,单纯癌1例,髓样癌1例。复发或转移灶
经CT和MI确诊。初次治疗后出现肝转移的中位时间为
【收稿日期】2013-02-2
个月(6-125个月),复发转移后均未行化疗。具有可测
作者单位】广州军区武汉总医院肿瘤科,湖北武汉430070
量和可评价的病灶,预计生存期>3个月。治疗前查血常规、
作者简介】饶智国(1965-),男,湖北成守人,博士,副主任医师,肝肾功能、尿常规;治疗后每周査血常规1次,连续2周:治
副教授,硕士生导师,主要从事乳腺癌及淋巴瘤的临
疗后2周内査肝肾功能1次,不正常者以后每2周复査1次
床诊治工作。E-maill:raozhiguo@hotmail.com