恩度联合化疗在HER-2阴性乳腺癌肝转移中的临床应用——附5例报告  

Endostar combined with chemotherapy in the treatment of HER-2 negative breast cancer

作　　者：袁霞[1] 张东生[1] 袁中玉[1] 何樱[2] 马慧敏[2] 李俊[2] 姜文奇[1] 

机构地区：[1]华南肿瘤学国家重点实验室中山医科大学肿瘤防治中心,广东广州510060 [2]惠州市中心人民医院肿瘤内科,广东惠州516001

出　　处：《癌症进展》2007年第6期604-607,共4页Oncology Progress

摘　　要：背景与目的乳腺癌肝转移患者预后差,对化疗敏感性差,生存期短。如何提高乳腺癌肝转移患者的治疗效果,提高生存期,是目前临床研究中亟需解决的问题。抗肿瘤新药重组人血管内皮抑素注射液(恩度,YH216)联合化疗治疗晚期非小细胞肺癌,能够显著提高客观疗效,延长患者的生存时间并改善生活质量。本组在HER-2阴性乳腺癌肝转移患者应用重组人血管内皮抑素联合化疗,观察近期疗效及毒副作用,为晚期乳腺癌肝转移的治疗提供有效的治疗参考。方法经病理组织学确诊的晚期乳腺癌肝转移患者5例(均为ER,PR,HER-2阴性),接受恩度联合化疗的方案治疗。其中恩度15mg,加入生理盐水500ml中缓慢静脉滴注4小时,第1～14天连续给药,间歇7天重复;同时联合既往未使用的或与既往治疗无交叉耐药的化疗药物,每21天为1个周期。结果本组5例患者中,总共完成的周期数为20个周期,平均4个周期1例。获得CR1例,PR2例,SD1例,PD1例,客观有效率(RR)为60%(3/5)。Ⅲ～Ⅳ度的毒性反应主要与化疗药物有关,5例患者在第2个周期结束后均出现不同程度的骨髓抑制,3例出现Ⅱ度白细胞下降(3/5,60%),1例出现血小板下降(1/5,20%)。5例均有不同程度恶心呕吐,1例出现轻度心律失常(未处理)。无其他毒副作用发生。结论恩度与化疗药物联合使用可以提高HER-2阴性乳腺癌肝转移患者的疗效,与化疗药物具有协同作用,其毒性低,安全性好,为乳腺癌肝转移提供新的治疗思路。Objective To explore the effectiveness and safely of endostar - combined therapy in Her - 2 negative breast cancer with liver metastisis. Methods Endostar combined with chemotherapy were administrated to 5 advanced breast cancer cases （ ER, PR and Her - 2 are negative） with liver metastisis, who were confirmed by histopathology or cytopathology. A total of 15mg endostar solved in 500ml of normal saline was intravenously admistered from day 1 to day 14, repeated later 7 days. The chemotherapy agents that were not used previously or not cross -resistant were administered simultaneously. The regimen was repeated every 21 days. Results Five patients were totally evaluated for efficacy and side effects after 20 cycles （ mean cycle was 4）. Among 5 evaluable patients, 1 patient achieved CR, 2 patients PR, and 1 patient SD and of PD. The objective response rate （RR） was 60% （3/5）. The G3/4 toxicities were included leukopenia （3/5, 60% ）, thrombocytopenia （ 1/5, 20% ）, nausea/vomiting （5/5, 100% ）, and arrhythmia （ 1/5, 20% ）, which were mainly related with chemotherapy agents. Conclusion The combination of chemotherapy with endostar provides a well - tolerated and active chemotherapy regimen for advanced breast cancer with liver metastisis.

关 键 词：重组人血管内皮抑素/恩度 乳腺癌肝转移 化疗 抗肿瘤血管形成 

分 类 号：R737.9[医药卫生—肿瘤] R73-73[医药卫生—临床医学]