紫杉醇联合顺铂治疗31例晚期乳腺癌的临床观察  

The Effect of Paclitaxel Combined with Cisplatin on Advanced Breast Cancer

作　　者：朱燕[1] 赵玉亮[1] 方红[1] 林蓉燕[1] 白羽[1] 于晶琳[1] 孙明霞[1] 徐玲[1] 王晓云[1] 

机构地区：[1]北京大学第一医院肿瘤化疗科,北京市100034

出　　处：《中国肿瘤临床》2008年第7期369-371,共3页Chinese Journal of Clinical Oncology

摘　　要：目的:观察紫杉醇联合顺铂治疗晚期转移性乳腺癌的疗效及不良反应。方法:采用紫杉醇联合顺铂治疗晚期转移性乳腺癌31例。紫杉醇135-175mg/m2静脉滴注第1天,顺铂70mg/m2静脉滴注第2天,21～28天为一周期。结果:总有效率58.1%,中位疾病进展时间7个月,中位生存时间20个月,1年生存率61.5%,3年生存率22.3%,5年生存率5.3%。初治组有效率显著优于复治组(77.8%:30.8%,P<0.05),曾经使用过蒽环类和未用过蒽环类药物患者的有效率分别为50%和66.7%(P>0.05),有1～2个转移灶患者及多个转移灶患者有效率分别为65%和45.5%(P>0.05),此方案对于内脏、淋巴结、软组织转移灶有效率相近,骨转移灶有效率相对低(28.6%),但尚未达统计学意义。主要不良反应为骨髓抑制、肌肉关节疼痛、周围神经毒性、胃肠道反应、肝功能异常,多为Ⅰ～Ⅱ度;Ⅲ～Ⅳ度不良反应主要为白细胞减少和胃肠道反应,发生率分别为16.1%和12.9%。结论:紫杉醇联合顺铂治疗晚期乳腺癌具有较好的疗效,不良反应可耐受。Objective： To evaluate the efficacy and safety of Paclitaxel-Cisplatin regimen in treating advanced breast cancer. Methods： A total of 31 patients with advanced breast cancer were treated with combination of Paclitaxel and Cisplatin. Paelitaxel was administered at 135-175mg/m^2 iv dl, and Cisplatin was administered at 70mg/m^2 iv d2. The above regimen was repeated every 21-28 days. Results： The overall response rate was 58.1%, with a median time to progression of 7 months. The median overall survival was 20 months. The 1-year, 3-year and 5-year overall survival rates were 61.5%, 22.3%, and 5.3%, respectively. The response rate was higher in patients with the initial treatment than in those with retreatment （77.8% vs. 30.8%, P〈0.05）. The response rate was 50% in patients previously exposed to anthracyclines and 66.7% in patients without previous exposure to anthraeyelines. The response rate of patients with one or two metastatic leisions and those with more leisions was 65% and 45.5%, respectively （P〉0.05）. Compared with metastases of viscera, lymph nodes and soft tissues, the response rate of bone metastasis was relatively low （28.6%）, but with no statistical significance. The main side effects were myelosuppression, arthralgia, muscle pain, peripheral neuropathy, gastrointestinal toxicity, and abnormal hepatic function. Most of the above side effects were grade Ⅰ- Ⅱ. The main grade Ⅲ-Ⅳ side effects were leukopenia and gastrointestinal toxicity with an incidence of 16.1% and 12.9%, respectively. Conclusion： The combination of Paclitaxel and Cisplatin has high efficacy in patients with advanced breast cancer. The side effects are tolerable.

关 键 词：乳腺癌 紫杉醇 顺铂 

分 类 号：R737.9[医药卫生—肿瘤] R979.1[医药卫生—临床医学]