2周期大剂量化疗联合自体外周血干细胞移植治疗转移性乳腺癌的临床疗效观察  

Clinical Study of Double Cycle High-dose Chemotherapy with Peripherial Blood Stem Cell Transplantation on Metastasis Breast Cancer

作　　者：张燕军[1] 任军[2] 贾军 黄若宇[1] 陈衍[1] 张红梅[1] 

机构地区：[1]第四军医大学西京医院,710032 [2]北京大学临床肿瘤医院内科,100016 [3]陕西省肿瘤医院内科,710061

出　　处：《实用癌症杂志》2005年第1期81-83,共3页The Practical Journal of Cancer

摘　　要：目的　观察2周期大剂量化疗方案联合自体外周血干细胞移植(D HDC )治疗转移性乳腺癌的疗效及其安全性。方法　将2 8例转移性乳腺癌患者分为2个组。D HDC组预处理方案:多西紫杉醇(DXL) 110～13 0mg/m2 +噻替哌(THPA ) 3 0 0～40 0mg/m2 +卡铂(CBP) 65 0～75 0mg/m2 ,预处理后第2天回输外周血干细胞,间隔3～5周重复,共治疗2个周期;S HDC组预处理方案:DXL 110～13 0mg/m2 +THPA 3 5 0～45 0mg/m2 +CBP 75 0～95 0mg/m2 ,预处理后第2天回输外周血干细胞,治疗1个周期。分别评价2组肿瘤客观缓解率和治疗相关的不良反应。结果　D HDC组和S HDC组的客观缓解率分别为66.7% (10 /15 ) ,5 4.5 % (6/11) ;2组白细胞毒性相近,但D HDC组血小板毒性较低,Ⅲ～Ⅳ度发热,恶心呕吐,腹泻和黏膜炎的发生例数较少。结论　D HDC治疗转移性乳腺癌客观缓解率较高,血小板毒性较轻,Ⅲ～Ⅳ度非血液学毒性发生例数较少,患者耐受性良好。Objective To evaluate the security and efficiency of double cycle high dose chemotherapy(D-HDC) with autologous peripheral blood stem cell transplantation on metastasis breast cancer.Methods 28 metastasis breast cancer patients were divided into two groups.The conditioning regimen of D-HCT was DXL110～130 mg/m2,THPA 300～400 mg/m2 and CBP 650～750 mg/m2.Hematopoietic stem cells were infused back the next day after conditioning.Two continuous cycles were given with a 3 to 5 weeks intermission.The conditioning regimen of S-HCT group was DXL110～130 mg/m2,THPA 350～450 mg/m2 and CBP750～950 mg/m2.The hematopoietic stem cells were infused back the next day after conditioning.Only one cycle was given.The objective remission rates of cancer and the treatment related toxicities were evaluated.Results The objective remission rates were 66.7%(10/15) and 54.5%(6/11) in D-HDC group and S-HDC group respectively.The incidence of treatment associated leukocytopenia was similar in two groups.But there were less thrombocytopenia,Ⅲ～Ⅳ degree fever,omitting,nausea,diarrhea and catarrh occurred in D-HDC group.Conclusion D-HDC treatment had higher objective remission rate but less haematopoietic system toxicity and less Ⅲ～Ⅳ degree toxicity of other system.D-HDC is quite feasible and tolerable in metastasis breast cancer patients.

关 键 词：转移性乳腺癌 临床疗效观察 细胞移植治疗 大剂量化疗 周期 自体外周血干细胞移植 客观缓解率 预处理方案 Ⅲ~Ⅳ度 乳腺癌患者 多西紫杉醇 白细胞毒性 血液学毒性 其安全性 化疗方案 不良反应 治疗相关 恶心呕吐 血小板 

分 类 号：R737.9[医药卫生—肿瘤] R743.33[医药卫生—临床医学]