20092510:510220,,。,、。[1-3]。2005120086(TT)54,。。11.154,26~70,46,karnofsky>80。,。B、X、、,、。,,。TNMb16,a21,b12,c5。:41,4,6,3。:110,234,310。1.2TT:THP()50mg/m2,1,;75mg/m2,1,1h,31。12h6h20mg,30min300mg,40mg,。,。(G-CSF)。、。。310~14d。1.3,、。(UICC)(completeresponse,CR)、(partialresponse,PR)、(stabledisease,SD)(PD)。(RR)CR+PR。3TNM。;,,,,,31。,WHO0~。1.4χ2。22.154,(RR)81.5%(44/54),(CR)14.8%(8/54),(PR)66.7%(36/54)。(PD),310~14d。,TNM,P<0.01(1)。2.2TT,,、,。(G-CSF)。2。:(TT)。:200512008654~,3TT,。:81.5%(44/54),14.8%(8/54),66.7%(36/54),。:TT,。;;;TNM00804162038221TNM1672200925103,。,。,5%~15%[4],50%~60%[5]。,:,、[6]。,、,。,:(1),,,[7];(2),;(3),。,,。,。(THP)、,DNAαβ,;DNA,DNA,G2,。(ADM),ADM,。50%~70%[8]。,,,,,。,,[9]。:,,。。[10]3~4。(TT)543,(RR)81.5%,8。,TNM,10~14d。,,。。。:,,。4BearHD,AndersonS,BrownA,etal.Theeffectontumorresponseofaddingsequentialpreoperativedocetaxeltopreoperativedxorubincinandcyclophosphamide:preliminaryresultsfromNationalSurgicalAdjuvantBreastandBowelProjectprotocolB-27[J].JClinOncol,2003,21(22):4165-4174.EspinosaE,MoralesS,BorregaP,etal.Docetaxelandhigh-doseepirubicinasneoadjuvantchemotherapyinlocallyadvancedbreastcancer[J].CancerChemotherPharmacol,2004,54(6):546-552.,,,.10[J].,2002,29(3):157-159..[M].:,2000:379-433..CTF[J].,2004,20(7):629-630.BeresfordMJ,HarrisAL,Ah-SeeM,etal.Therelationshipoftheneoangiogenicmarker,endoglin,withresponsetoneoadjuvantchemotherapyinbreastcancer[J].BrJCancer,2006,95(12):1683-1688.HanrahanEO,HennessyBT,ValeroV.Neoadjuvantsystemictherapyforbreastcancer:anoverviewandreviewofrecentclinicaltrials[J].ExpertOpinPharmacother,2005,6(9):1477-1491.CharfareH,LimongelliS,PurushothamAD.Neoadjuvantchemotherapyinbreastcancer[J].BrJSurg,2005,92(1):14-23.NabboltzJM,ResseDM,LindsayMA,etal.Evidencefortheuseofchemotherapyinbreastcancer[J].IntJClinOncol,2002,7(4):254-264.,,.364[J].,2008,13(6):508-510.(:2008-10-15:)[1][2][3][4][5][6][7][8][9][10]00490384005410131416262623038023180000000002TT1673