Chemotherapy of paclitaxel liposome plus pirarubicin combined with radiotherapy for locally advanced breast cancer

doi:10.3877/cma.j.issn.1674-0807.2016.02.004

Abstract

Abstract:

Objective

To analyze the curative and adverse effects of paclitaxel liposome plus pirarubicin combined with radiotherapy for the patients with locally advanced breast cancer.

Methods

Totally 216 locally advanced breast cancer patients treated in Department of Breast Surgery,Chongqing Cancer Institute between January 2008 and December 2012 were involved for a prospective study. According to their wishes,the patients were divided into research group (n=112) and control group (n=104). In research group, the patients received intervenous drop infusion of paclitaxel liposome and paclitaxel on day 1, and synchronous radiotherapy for 20 days. In control group, the patients received intervenous drop infusion of paclitaxel liposome and paclitaxel on day 1. After 4 cycles of neoadjuvant chemotherapy, the curative and adverse effects were evaluated. The total effective rate, surgical resection rate and cancer metastasis rate between two groups were compared using χ² test, the tumor cell apoptosis index using t test, adverse reaction rates using nonparametric test and survival rate using Log-rank test.

Results

The total effective rate in research group was 86.6%(97/112),significantly higher than 68.3% in control group(71/104)(χ²=10.492, P=0.001); the surgical resection rate in research group was 95.5%(107/112),significantly higher than the 82.7% in control group (86/104)(χ²=9.349, P=0.002). After treatment,tumor cell apoptosis index in research group was(64.76±5.39)%,significantly higher than (53.81±4.91)% in control group (t=15.567, P=0.000);2-year progression-free survival in research group was 83.0% (93/112),significantly higher than 70.2%(73/104) in control group (χ²=5.000, P=0.025);overall survival in research group was 88.4%(99/112),significantly higher than 77.9%(81/104)in control group (χ²=4.287, P=0.038). Distant metastasis rate showed a significant difference between two groups [17.9%(20/112) than 27.9%(29/104),χ² =3.092,P=0.079]. The incidences of myelosuppression, gastrointestinal reaction, cardiac toxicity and liver dysfunction were 65.2% (73/112), 67.0% (75/112), 14.3% (16/112) and 13.4% (15 / 112) in research group,61.5% (64/104),64.4% (67/104),11.5% (12/104) and 12.5% (13/104) in control group respectively, indicating no statistically significant diffenrence (Z=-0.867, -0.688, -0.614, -0.183,P= 0.386,0.491,0.539,0.855).

Conclusion

Chemotherapy of paclitaxel liposome plus pirarubicin combined with radiotherapy has definite efficacy for locally advanced breast cancer patients, with no obvious adverse effect, thus it is worthy of clinical application.

Key words: Breast neoplasms, Paclitaxel, Liposomes, Pirarubicin, Chemotherapy, Radiotherapy

Wei Li, Geli Jiang, Xiaohua Zeng, Zhongxun Xiong, Jie Luo. Chemotherapy of paclitaxel liposome plus pirarubicin combined with radiotherapy for locally advanced breast cancer[J]. Chinese Journal of Breast Disease(Electronic Edition), 2016, 10(02): 82-86.

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References 23

[1]	Papadimitriou K, Ardavanis A, Kountourakis P. Neoadjuvant therapy for locally advanced breast cancer: Focus on chemotherapy and biological targeted treatments' armamentarium[J]. J Thorac Dis,2010,2(3):160-170.
[2]	Smith TA, Cheyne RW. Predicting tumour response to anti-HER1 therapy using medical imaging: a literature review and in vitro study of[18F]-FDG incorporation by breast cancer cells responding to cetuximab [J]. Br J Biomed Sci,2011,68(3):158-166.
[3]	Rustogi A, Budrukkar A, Dinshaw K, et al. Management of locally advanced breast cancer: evolution and current practice [J]. J Cancer Res Ther,2005,1(1):21-30.
[4]	Vale C, Tierney JF, Stewart LA, et al. Reducing uncertainties about the effects of chemoradiotherapy for cervical cancer:a systematic review and meta-analysis of individual patient data from 18 randomized trials[J]. J Clin Oncol,2008,26(35):5802-5812.
[5]	Wee J, Tan EH, Tai BC, et al. Randomized trial of radiotherapy versus concurrent chemoradiotherapy followed by adjuvant chemotherapy in patients with American Joint Committee on Cancer/International Union against cancer stage Ⅲand Ⅳnasopharyngeal cancer of the endemic variety [J]. J Clin Oncol,2005,23(27):6730-6738.
[6]	Edge S, Byrd DR, Compton CC, et al. AJCC cancer staging manual[M]. New York: springer-verlag,2010:347-376.
[7]	Eisenhauer EA, Therasse P, Bogaerts J, et al. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1) [J].Eur J Cancer,2009,45(2):228-247.
[8]	Miller AB,Hoogstrater B,Stagnet M,et al. Reporting results of cancer treatment[J].Cancer,1981,47(1):207-214.
[9]	Cux JD,Stetz J,Pajak TF. Toxicity criteria of the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC) [J].Int J Radiat Oncol Biol Phys,1995,31(5):1341-1346.
[10]	郭小毛,梅欣,辛倩.局部晚期乳腺癌的治疗进展[J]. 中国症杂志,2006,16(6):409-416.
[11]	Amar S, Roy V, Perez EA. Treatment of metastatic breast cancer:looking towards the future[J]. Breast Cancer Res Treat,2009,114(3):413-422.
[12]	Liu SV, Melstrom L, Yao K, et al. Neoadjuvant therapy for breast cancer[J]. J Surg Oncol,2010,101(4):283-291.
[13]	吴晓翠,李会荣,王跃伟. 紫杉醇脂质体联合奈达铂同步放化疗治疗不可手术的宫颈癌疗效观察[J]. 中国实用医药, 2014, 9(14):158-159.
[14]	Soepenberg O, Sparreboom A, de Jonge MJ, et al. Real-time pharmacokinetics guiding clinical decisions; phase I study of a weekly schedule of liposome encapsulated paclitaxel in patients with solid tumours [J]. Eur J Cancer,2004,40(5):681-688.
[15]	Shimizu C, Ando M, Kouno T, et al. Current trends an controversies over pre-operative chemotherapy for women with operable breast cancer[J]. Jpn J Clin Oncol,2007,37(1):1-8.
[16]	Alvarez RH, Booser DJ,Cristofanilli M,et al. Phase 2 trial of primary systemic therapy with doxorubicin and docetaxel followed by surgery,radiotherapy, and adjuvant chemotherapy with cyclophosphamide,methotrexate, and 5-fluorouracil based on clinical and pathologic response in patients with stage ⅡB to Ⅲbreast cancer: long-term results from the University of Texas M. D. Anderson Cancer Center Study ID97-099 [J]. Cancer,2010,116(5):1210-1217.
[17]	Chen S,Huang L,Chen CM, et al. Progesterone receptor loss identifies luminal-type local advanced breast cancer with poor survival in patients who fail to achieve a pathological complete response to neoadjuvant chemotherapy [J]. Oncotarget,2015,6(20):18 174-18 182.
[18]	Karpinska A, Safranow K,Kladny J,et al. The influence of obesity on results of AT (doxorubicin plus docetaxel) neoadjuvant chemotherapy in locally advanced breast cancer patients [J]. Pol Przegl Chir,2015,87(5):231-237.
[19]	Lambert K,Mokbel K. Does post-mastectomy radiotherapy represent a contraindication to skin-sparing mastectomy and immediate reconstruction:an update[J].Surg Oncol,2012,21(2): e67-74.
[20]	龙斌,谭兵,周宪,等.放化疗联合治疗局部晚期鼻咽癌的临床观察[J]. 中国肿瘤临床,2012,39(20):1556-1558.
[21]	朱彦玲,章文华,张红,等. 局部晚期宫颈癌术前新辅助治疗方案的比较[J]. 中华肿瘤杂志,2013,35(4):309-310.
[22]	Eifel PJ, Winter K, Morris M, et al. Pelvic irradiation with concurrent chemotherapy versus pelvic and para-aoritc irradiation for high-risk cervical cancer: an update of radiation therapy oncology group trial(RTOG) 90-01[J]. J Clin Oncol,2004,22(5):872-880.
[23]	Rose PG. Chemoradiotherapy for cervical cancer [J]. Eur J Cancer,2002,38(2):270-278.

组别	例数	年龄(例)		肿瘤直径(cm)	区域淋巴结(例)		病理类型(例)		分子分型(例)
组别	例数	＜50岁	≥50岁	肿瘤直径(cm)	N_0～1	N_2～3	浸润性导管癌	浸润性小叶癌	luminal A型	luminal B型	HER-2过表达型	基底样型
研究组	112	67	45	6.63±1.16	26	86	105	7	21	45	27	19
对照组	104	62	42	6.60±1.17	23	81	98	6	20	41	24	19
检验值		χ²=0.001		t=0.167	χ²=0.037		χ²=0.022		χ²=0.091
P值		0.975		0.963	0.847		0.882		0.993

组别	例数	年龄(例)		肿瘤直径(cm)	区域淋巴结(例)		病理类型(例)		分子分型(例)
组别	例数	＜50岁	≥50岁	肿瘤直径(cm)	N_0～1	N_2～3	浸润性导管癌	浸润性小叶癌	luminal A型	luminal B型	HER-2过表达型	基底样型
研究组	112	67	45	6.63±1.16	26	86	105	7	21	45	27	19
对照组	104	62	42	6.60±1.17	23	81	98	6	20	41	24	19
检验值		χ²=0.001		t=0.167	χ²=0.037		χ²=0.022		χ²=0.091
P值		0.975		0.963	0.847		0.882		0.993

组别	例数	肿瘤细胞凋亡指数
组别	例数	治疗前	治疗后
研究组	112	17.32±1.47	64.76±5.39^a
对照组	104	17.02±1.88	53.81±4.91^b
t值		1.317	15.567
P值		0.189	＜0.001

组别	例数	肿瘤细胞凋亡指数
组别	例数	治疗前	治疗后
研究组	112	17.32±1.47	64.76±5.39^a
对照组	104	17.02±1.88	53.81±4.91^b
t值		1.317	15.567
P值		0.189	＜0.001

组别	例数	骨髓抑制			胃肠道反应			心脏毒性			肝功能损害			皮肤损伤程度
组别	例数	无	Ⅰ～Ⅱ	Ⅲ～Ⅳ	无	Ⅰ～Ⅱ	Ⅲ～Ⅳ	无	Ⅰ～Ⅱ	Ⅲ～Ⅳ	无	Ⅰ～Ⅱ	Ⅲ～Ⅳ	0级	1～2级	3～4级
研究组	112	39	57	16	37	54	21	96	14	2	97	12	3	87	25	0
对照组	104	40	54	10	37	52	15	92	11	1	91	10	3	104	0	0
Z值		-0.867			-0.688			-0.614			-0.183			-5.112
P值		0.386			0.491			0.539			0.855			＜0.001

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