评价高剂量表阿霉素联合环磷酰胺和氟尿嘧啶在乳腺癌新辅助治疗中的临床疗效和毒性。

2001年1月至2006年6月经空心针穿刺活检组织病理学诊断为乳腺癌的患者89例，术前接受表阿霉素100 mg/m²（第1天）、环磷酰胺600 mg/m²（第1天）、氟尿嘧啶600 mg/m²（第1天)方案化疗（FEC100），21天1个疗程，共4个疗程。

联合化疗治疗总有效率为80.5%，其中临床完全缓解（cCR）19.1%（17/89），部分缓解（cPR）61.8%（55/89），病情稳定（SD）19.1%（17/89），无病情进展（PD）病例。病理完全缓解（pCR）16例（18.0%），其中13例（14.6%）化疗后原发肿瘤手术切除标本上未见肿瘤组织残留，3例（3.4%）仅见原位癌组织残留。Ⅲ~Ⅳ度的中性粒细胞减少发生率为29.2%，3例出现中性粒细胞减少性发热。非血液学毒性主要为胃肠道反应和脱发，12例（13.5%）出现Ⅲ度恶心呕吐，71例（79.8%）发生Ⅲ度脱发，随访期间未出现心脏毒性病例。中位随访37个月，总生存率87.6%（78/89），无病生存率为83.2%（74/89）。

高剂量表阿霉素联合环磷酰胺和氟尿嘧啶在乳腺癌新辅助化疗中疗效满意，生存率与文献报道的相似，耐受性好。

To evaluate the clinical and pathologic response and toxicity of cyclophosphamide and epirubicin and fluorouracil as neoadjuvant chemotherapy in the treatment of breast cancer, and observe the long-term effect.

From January 2001 to June 2006, 89 patients confirmed breast cancer by core needle biopsy were enrolled onto this clinical trial and treated with neoadjuvant chemotherapy,the regimen containing cyclophosphamide 600 mg/m² (day 1) and epirubicin 100 mg/m² (day 1) and 5-fluorouracil 500 mg/m² (day 1) (FEC100) was administered every 3 weeks for 4 cycles before local treatment.

The clinical overall response was 80.5%. cCR was 19.1%(17/89), cPR was 61.8%(55/89), SD was 19.1%(17/89), and no case was PD. Pathological complete response (pCR) was found in 16 cases (18.0%). Leukopenia with grade 3 and 4 occurred in 26 patients. Febrile leukopenia occurred in 3 patients. Nausea and vomitting with grade 3 occurred in 12 patients(13.5%). 71 cases had grade 3 alopecia(79.8%). There was no congestive heart failure. At a median follow-up of 37 months, the overall survival rate(OS)was 86.6% and the disease free survival rate(DFS)was 81.7%. The rates of OS and DFS for patients with a pCR were both 93.7%.

The FEC100 regimen is a very active and well-tolerated regimen in the neoadjuvant chemotherapy for breast cancer.