乳癌根治术后放化疗对乳腺癌中晚期患者T淋巴细胞及生存率的影响

周吉照　王静

[摘要] 目的 探讨乳癌根治术后放化疗对乳腺癌中晚期患者T淋巴细胞及生存率的影响。 方法 选择本科2010年6月～2011年12月收治的乳腺癌中晚期患者56例，治疗方案为手术+放疗+化疗，手术方式为乳癌根治术。术后进行化疗分别于第1、8天给予多西紫杉醇75 mg/m2静脉滴注，缓慢滴注时间为3 h；术后第1～3天给予顺铂溶于生理盐水250 ml静脉滴注，剂量20 mg/m2，时间1 h，3周为1个周期；三维适形放疗为DT 2 Gy/次，1次/d，5次/周，观察患者治疗前后相关免疫指标的变化及生存率。 结果 患者治疗后的CD3、CD4、CD8、CD4/CD8及NK较治疗前均降低，差异有统计学意义（P<0.05）。乳癌根治术56例，乳癌改良根治术占33.93%（19/56）。术后随访1年局控率达到75.0%（42/56），1年生存率达到80.36%（45/56），2年局控率达到21.43%（12/56），2年生存率达到26.78%（15/56），临床总有效率为76.78%（43/56）。 结论 乳腺癌中晚期患者乳癌根治术后放化疗对机体免疫力可造成一定的影响，治疗中应考虑其不良反应，针对性地采取相应治疗方案，以提高临床疗效。

[关键词] 乳腺癌中晚期；乳癌根治术；放疗；化疗

[中图分类号] R737.9 [文献标识码] A [文章编号] 1674-4721（2014）04（a）-0031-03

[Abstract] Objective To investigate the impact of radiotherapy and chemotherapy after radical operation of breast cancer on T lymphocyte and survival rate in patient with advanced breast cancer. Methods 56 patients with advanced breast cancer in our department from June 2010 to December 2011 were selected，treatment option was surgery+radiotherapy+chemotherapy，operation mode was radical operation of breast cancer.Postoperative chemotherapy was given in the first 1，8 days docetaxel 75 mg/m2 intravenously，slow infusion time was 3 hours，1 to 3 days after cisplatin dissolved in 250 ml of saline infusion，the dose 20 mg/m2 infusion time 1 hour，3 weeks for 1 cycle.Three-dimensional conformal radiotherapywas DT 2 Gy/time，1 time/day，5 times/week，before and after treatment related immune system indicator and survival rate was observed respectively. Results CD3，CD4，CD8，CD4/CD8 and NK after treatment was lower than before treatment respectively，with statistical difference（P<0.05）.56 cases of radical operation of breast cancer，modified radical mastectomy for breast cancer accounted for 33.93%（19/56）.Patients were followed up for 1-year local control rate was 75.0%（42/56），1-year survival rate was 80.36%（45/56），2-year local control rate was 21.43%（12/56），2-year survival rate was 26.78%（15/56），the total clinical efficiency rate was 76.78%（43/56）. Conclusion Patients with advanced breast cancer after radical radiotherapy and chemotherapy for breast cancer immunity have been affected，clinical adverse reaction should be considered in this regard，take the appropriate treatment program targeted in order to improve clinical effect.

[Key words] Advanced breast cancer；Radical operation of breast cancer；Radiotherapy；Chemotherapy

我国乳腺癌发病率目前呈上升趋势，占女性新发恶性肿瘤的30%，成为女性最常见的恶性肿瘤之一[1]。随着分子生物学技术及诊疗规范化水平的不断提高，乳腺癌的发病率虽然总体呈升高状态，但据统计死亡率呈不断下降趋势。本研究旨在探讨患者乳癌根治术后放化疗对机体免疫力及生存率的影响。