乳癌根治術后放化療對乳腺癌中晚期患者T淋巴細胞及生存率的影響

周吉照　王靜

[摘要] 目的 探討乳癌根治術后放化療對乳腺癌中晚期患者T淋巴細胞及生存率的影響。 方法 選擇本科2010年6月～2011年12月收治的乳腺癌中晚期患者56例，治療方案為手術+放療+化療，手術方式為乳癌根治術。術后進行化療分別于第1、8天給予多西紫杉醇75 mg/m2靜脈滴注，緩慢滴注時間為3 h；術后第1～3天給予順鉑溶于生理鹽水250 ml靜脈滴注，劑量20 mg/m2，時間1 h，3周為1個周期；三維適形放療為DT 2 Gy/次，1次/d，5次/周，觀察患者治療前后相關免疫指標的變化及生存率。 結果 患者治療后的CD3、CD4、CD8、CD4/CD8及NK較治療前均降低，差異有統計學意義（P<0.05）。乳癌根治術56例，乳癌改良根治術占33.93%（19/56）。術后隨訪1年局控率達到75.0%（42/56），1年生存率達到80.36%（45/56），2年局控率達到21.43%（12/56），2年生存率達到26.78%（15/56），臨床總有效率為76.78%（43/56）。 結論 乳腺癌中晚期患者乳癌根治術后放化療對機體免疫力可造成一定的影響，治療中應考慮其不良反應，針對性地采取相應治療方案，以提高臨床療效。

[關鍵詞] 乳腺癌中晚期；乳癌根治術；放療；化療

[中圖分類號] R737.9 [文獻標識碼] A [文章編號] 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

我國乳腺癌發病率目前呈上升趨勢，占女性新發惡性腫瘤的30%，成為女性最常見的惡性腫瘤之一[1]。隨著分子生物學技術及診療規范化水平的不斷提高，乳腺癌的發病率雖然總體呈升高狀態，但據統計死亡率呈不斷下降趨勢。本研究旨在探討患者乳癌根治術后放化療對機體免疫力及生存率的影響。