| Bachgroug and Objective:1. Comparison the clinical curative effect between Docetaxel combination with CTX and 5-Fu chemotherapy and THP combination with CTX and 5-Fu chemotherapy.And a comparative analysis of efficacy was made from the number of positive lymph nodes and estrogen receptor (ER)expression status.2. To discuss the changes in serum tumor markers before and after combination chemotherapy. To discuss the relationship between the clinical curative effect and the quantity alteration of tumor markers, and the relation-ship between tumor markers curative and clinical curative effect evaluation.Materials and Methods:1. The comparison the clinical curative effect were detected by retrospective study. The investigation group was 16 patients who were treated with Docetaxel combination with CTX and 5-Fu in our tumor center. The control group was 14 patients who were treated with THP combination with CTX and 5-Fu. Docetaxel 80mg/m2,in vein drip,4 hours or THP 50mg/m2, in vein drip,3 hours,1st day, CTX 600mg/m2,in vein bolus,3rd day,5-Fu 400mg/m2, in vein bolus,3rd day. One cycle was 21 days, the curative effect was evaluated at least over two cycles. Acorrding to the number of positive lymph nodes,the patiens were divided into three groups:0/1-3/=4, and two groups patiens with estrogen receptor (ER) positive or negative.The datastatistic software is SPSS13.0.2. All the patients have received at least over two cycles treatments followed by method one. To detecte the changes in serum tumor markers before and after Docetaxel combination with CTX and 5-Fu chemotherapy.The tumor markers were detected by ELISA methods. The datastatistic software is SPSS13.0.The results:1. The obiective response rate and clinical benefit res-ponse of research group treated with Docetaxel combination with CTX and 5-Fu to therapy breast cancer were obviously higher th-an those of control group treated with THP combination with CTX and 5-Fu, at the same time, the invalid rate of research group was lower than that of control group. According to statistical analysis, there was a significant difference between clinical therapeutic effect of two groups(p<0.05). The response rates were 60.0% and 25.0% in initially treated FDC group and FTC group,54.5% and 11.1% in re-treated FDC group and FTC group,respectively. FDC group comparied with FTC group,there was no significant difference(P>0.05) in initial treatment response rate and re-treated response rate. The response rates of patients with IIIC period and IVperiod 57.1% and 55.6% in FDC group,16.7% and 25.0% in FTC group,â…¢C period comparied withâ…£period, there was no significant difference(P>0.05) in the response rate in the two groups.60.0% and 25.0% in initially treated FDC group and FTC group,54.5% and 11.1% in re-treated FDC group and FTC group,respectively. FDC group comparied with FTC group,there was no significant difference(P>0.05) in initial treatment response rate and re-treated response rate.2.Comparison of adverse reactions:The main adverse reactions were leucopenia, thrombocytopenia,alopecia,nausea,vomiting and liver dysfunction,etc. After symptomatic treatment,the patients can tolerate adverse reactions. According to statistical analysis, there was no significant difference between adverse reaction of two groups (p>0.05).3.The change of serum tumor marker before and after treatment of combination chemo-therapy:â‘ After combination chemotherapy, the level of four gerenal serum tumor marker were lower than it before combination chemotherapy,especially there were significant difference in CA153 and CEA(P<0.05),however, there was no significant difference in CA125(p>0.05);â‘¡The numerical value of serum tumor marker after treatment distinctly changed with therapeutic effect. There were significant difference in the variance of CA153 and CEA in the groups of distinct therapeutic effect. CA153 and CEA had a more superiority than CA125 in monitoring clinical therapeutic effect.â‘¢The evaluation to thera-peutic effect of tumor marker basically accorded with the evaluation to clinical therapeutic effect.The total coincidence of CA153, CA125 and CEA were 45.9%,24.2% and 45.5%, respectively. There were all significant diference except CA125(p>0.05).4.No matter which chemotherapy option was choosen, the obiective response rate and clinical benefit response of the patients with ER-negative were obviously higher than those of ER-positive patients.Conclusions:1. For patients with 1-3 lymph node metastasis,the obiective response rate and clinical benefit res-ponse of research group treated with Docetaxel combination with CTX and 5-Fu to therapy breast cancer were obviously higher th-an those of control group treated with THP combination with CTX and 5-Fu.2. According to statistical analysis, there was no significant difference between adverse reaction of two groups.3. CA153 and CEA could be levels to monitor the therapeutic effects of breast cancer patients,and evaluate their therapeutic effects.After the chemotherapeutic plan which used Docetaxel or THP combination with CTX and 5-Fu,the changes of breast cancer patients' tumor markers could reflect therapeutic effects partly, and after therapies, the levels of serum tumor markers all decreased at different degrees. Compared with the condition before therapies, CA153 and CEA of serum all had significant difference, while CA125 didn't have.Breast cancer tumor markers had great clinical value on evaluating therapeutic effects. CA153 and CEA of serum had more advantages on monitoring the therapeutic effects of breast cancer patients and reflecting the development of patients' conditions or the good effects.4.ER-negative patients benefit more from adjuvant chemotherapy than ER-positive ones. |
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