本文選題：乳腺癌　切入點：化療　出處：《華北理工大學(xué)》2015年碩士論文

【摘要】：目的比較不同化療方案治療乳腺癌患者外科手術(shù)治療后的生存情況,為術(shù)后化療方案的選擇提供科學(xué)依據(jù)。方法采用臨床隨訪研究方法以華北理工大學(xué)附屬醫(yī)院2004年1月至2009年12月間乳腺癌術(shù)后患者作為研究對象,由2名研究生收集乳腺癌患者的一般資料、臨床資料和化療方案。由2名研究生通過電話隨訪和查閱病例的方式對乳腺癌患者的5年生存情況進(jìn)行隨訪。采用Excel2003建立數(shù)據(jù)庫,SPSS17.0統(tǒng)計軟件進(jìn)行數(shù)據(jù)分析。根據(jù)其應(yīng)用的化療方案不同分為蒽環(huán)類藥物方案組、蒽環(huán)類聯(lián)合紫杉類藥物方案組、CMF方案組、其他藥物方案組。通過電話隨訪的方式了解不同化療藥物方案的乳腺癌患者術(shù)后5年的生存情況。比較分析蒽環(huán)類藥物方案組和蒽環(huán)類聯(lián)合紫杉類藥物方案組患者的生存率、轉(zhuǎn)移率、總生存期(Overall Survival,OS)、無病生存期(Disease Free Survival,DFS)。利用COX風(fēng)險回歸模型調(diào)整對乳腺癌術(shù)后患者預(yù)后的影響因素,比較不同化療藥物方案對乳腺癌患者術(shù)后生存情況的差異。結(jié)果蒽環(huán)類方案組與蒽環(huán)類聯(lián)合紫杉類方案組乳腺癌術(shù)后患者的一般情況和臨床資料比較的結(jié)果顯示,兩組間在年齡、BMI、血壓、月經(jīng)情況、病理學(xué)情況、受體表達(dá)、術(shù)式等方面均無差異(P0.05),而兩組間淋巴結(jié)轉(zhuǎn)移情況和放療情況方面存在差異(P0.05)。采用Kaplan-Meier生存分析法對隨訪結(jié)果分析,蒽環(huán)類藥物方案組和蒽環(huán)類聯(lián)合紫杉類藥物方案組OS分別為57.0±0.8月和54.7±1.4月,DFS分別為52.6±1.3月和50.2±1.8月。兩組患者1年總生存率分別為98.3%和94.2%、轉(zhuǎn)移率分別為1.7%和4.3%;3年總生存率為94.9%和89.9%、轉(zhuǎn)移率為16.1%和20.3%;5年生存率為86.0%和81.6%、轉(zhuǎn)移率為22.9%和30.4%,兩種化療方案組間生存率、轉(zhuǎn)移率經(jīng)Log-Rank檢驗差異無統(tǒng)計學(xué)意義(P0.05)。按淋巴結(jié)轉(zhuǎn)移分層,在同種淋巴結(jié)轉(zhuǎn)移情況中不同化療方案組患者術(shù)后1年、3年、5年生存率和轉(zhuǎn)移率無統(tǒng)計學(xué)差異(P0.05)。按放療情況分層后結(jié)果顯示,同樣的放療情況中不同化療藥物方案組患者的生存率與轉(zhuǎn)移率均無統(tǒng)計學(xué)差異(P0.05)。采用COX風(fēng)險回歸模型調(diào)整年齡、BMI、初潮、淋巴結(jié)轉(zhuǎn)移、術(shù)式、付費(fèi)方式、臨床分期等因素后,結(jié)果顯示化療方案不是乳腺癌術(shù)后患者預(yù)后的獨立影響因素(P=0.235)。分別按淋巴結(jié)轉(zhuǎn)移情況、放療情況進(jìn)行分層后,結(jié)果仍未發(fā)現(xiàn)化療方案是乳腺癌術(shù)后患者的獨立影響因素(P0.05)。結(jié)論蒽環(huán)類藥物方案與蒽環(huán)類聯(lián)合紫杉醇類藥物方案對乳腺癌患者術(shù)后5年總生存、無病生存未發(fā)現(xiàn)差別。
[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.

【學(xué)位授予單位】：華北理工大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R737.9

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