不同化疗方案的乳腺癌术后患者的生存疗效分析

发布时间：2018-03-27 08:59

本文选题：乳腺癌　切入点：化疗　出处：《华北理工大学》2015年硕士论文

【摘要】：目的比较不同化疗方案治疗乳腺癌患者外科手术治疗后的生存情况,为术后化疗方案的选择提供科学依据。方法采用临床随访研究方法以华北理工大学附属医院2004年1月至2009年12月间乳腺癌术后患者作为研究对象,由2名研究生收集乳腺癌患者的一般资料、临床资料和化疗方案。由2名研究生通过电话随访和查阅病例的方式对乳腺癌患者的5年生存情况进行随访。采用Excel2003建立数据库,SPSS17.0统计软件进行数据分析。根据其应用的化疗方案不同分为蒽环类药物方案组、蒽环类联合紫杉类药物方案组、CMF方案组、其他药物方案组。通过电话随访的方式了解不同化疗药物方案的乳腺癌患者术后5年的生存情况。比较分析蒽环类药物方案组和蒽环类联合紫杉类药物方案组患者的生存率、转移率、总生存期(Overall Survival,OS)、无病生存期(Disease Free Survival,DFS)。利用COX风险回归模型调整对乳腺癌术后患者预后的影响因素,比较不同化疗药物方案对乳腺癌患者术后生存情况的差异。结果蒽环类方案组与蒽环类联合紫杉类方案组乳腺癌术后患者的一般情况和临床资料比较的结果显示,两组间在年龄、BMI、血压、月经情况、病理学情况、受体表达、术式等方面均无差异(P0.05),而两组间淋巴结转移情况和放疗情况方面存在差异(P0.05)。采用Kaplan-Meier生存分析法对随访结果分析,蒽环类药物方案组和蒽环类联合紫杉类药物方案组OS分别为57.0±0.8月和54.7±1.4月,DFS分别为52.6±1.3月和50.2±1.8月。两组患者1年总生存率分别为98.3%和94.2%、转移率分别为1.7%和4.3%;3年总生存率为94.9%和89.9%、转移率为16.1%和20.3%;5年生存率为86.0%和81.6%、转移率为22.9%和30.4%,两种化疗方案组间生存率、转移率经Log-Rank检验差异无统计学意义(P0.05)。按淋巴结转移分层,在同种淋巴结转移情况中不同化疗方案组患者术后1年、3年、5年生存率和转移率无统计学差异(P0.05)。按放疗情况分层后结果显示,同样的放疗情况中不同化疗药物方案组患者的生存率与转移率均无统计学差异(P0.05)。采用COX风险回归模型调整年龄、BMI、初潮、淋巴结转移、术式、付费方式、临床分期等因素后,结果显示化疗方案不是乳腺癌术后患者预后的独立影响因素(P=0.235)。分别按淋巴结转移情况、放疗情况进行分层后,结果仍未发现化疗方案是乳腺癌术后患者的独立影响因素(P0.05)。结论蒽环类药物方案与蒽环类联合紫杉醇类药物方案对乳腺癌患者术后5年总生存、无病生存未发现差别。
[Abstract]:Objective to compare the survival of chemotherapy in the treatment of breast cancer patients after surgical intervention, and provide scientific basis for the solution of postoperative chemotherapy choice. Methods clinical follow-up in the North China Polytechnic University Hospital from January 2004 to December 2009 with breast cancer after operation as the research object. By 2 graduate students collect general information of breast cancer in patients with clinical data, and chemotherapy. By 2 graduate students were followed up by telephone follow-up and review of cases of breast cancer patients 5 years survival. Excel2003 was used to establish database and SPSS17.0 statistical software to analyze the data. According to the application of chemotherapy were divided into anthracycline regimen group, anthracycline combined taxane regimen group, CMF group and other drug regimens. Through telephone follow-up to understand different chemotherapy of breast cancer 5 years after the operation. The survival compared with anthracycline regimen group and anthracycline plus taxane regimen in patients with survival rate, metastasis rate of overall survival (Overall, Survival, OS), disease-free survival (Disease Free, Survival, DFS). Using COX regression model to adjust the factors affecting the prognosis of patients with breast cancer after surgery, comparing different chemotherapy survival differences for patients with breast cancer after operation. Results the anthracycline regimen group and anthracycline plus taxane group compared with the general condition and clinical data of patients with breast cancer after operation, the results showed that among the two groups in age. BMI, blood pressure, menstrual status, pathological conditions, receptor expression, there was no significant difference in aspects of operation (P0.05), and between the two groups of lymph node metastasis and radiotherapy are differences (P0.05). Using Kaplan-Meier survival analysis analysis of follow-up results, anthracycline The regimen group and anthracycline plus taxane regimen group OS were 57 + 0.8 and 54.7 + 1.4 months, DFS = 52.6 + 1.3 and 50.2 + 1.8 months. Two patients 1 year survival rates were 98.3% and 94.2%, the transfer rate is respectively 1.7% and 4.3%; 3 years total the survival rate was 94.9% and 89.9%, the transfer rate is 16.1% and 20.3%; the 5 year survival rate was 86% and 81.6%, the transfer rate is 22.9% and 30.4%, two kinds of chemotherapy group survival rate, metastasis rate by Log-Rank test showed no significant difference (P0.05). According to the lymph node metastasis of lymph nodes in the same layer, 1 years transfer, different chemotherapy treatment group of patients after 3 years, 5 years survival rate and metastasis rate showed no significant difference (P0.05). According to the situation of radiotherapy after stratification results showed the same radiotherapy in different chemotherapy group survival rate and metastasis rate were not statistically significant (P0.05) by COX. Risk regression model BMI, adjusted for age, menarche, lymph node metastasis, operation, payment methods, clinical stage and other factors, the results show that independent prognostic factor than chemotherapy after breast cancer surgery (P=0.235). According to the lymph node metastasis after radiotherapy were stratified, the results have not yet been found chemotherapy are independent factors postoperative patients with breast cancer (P0.05). Conclusion anthracycline and anthracycline plus taxane program for breast cancer patients after 5 year overall survival, disease-free survival found no difference.

【学位授予单位】：华北理工大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R737.9

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