紫杉醇为主的联合方案治疗蒽环类耐药的晚期乳腺癌46例  

Paclitexal-based combination chemotherapy in the treatment of fourty-six patients with anthracycline-resistant advanced breast cancer

作　　者：姚春梅[1] 尹刘[1] 

机构地区：[1]淮北矿工总医院肿瘤科,235000

出　　处：《安徽医学》2009年第4期418-420,共3页Anhui Medical Journal

摘　　要：目的探讨紫杉醇(paclitexal PTX)为主的联合方案治疗蒽环类耐药的晚期乳腺癌患者的疗效及不良反应。方法46例蒽环类药物治疗失败的晚期乳腺癌患者,23例予紫杉醇联合顺铂(DDP)化疗(TP方案:PTX135～175mg/m2,持续静脉滴注3h,d1,DDP80mg/m2,静脉滴注,d2-4);23例予紫杉醇联合卡培他滨(capecitabine CAP)化疗(TC方案:PTX135～175mg/m2,持续静脉滴注3h,d1,CAP1250～1650mg/(m2.d),分早晚2次口服,d1-14,休息7d,21d为1周期,3周期后评价疗效,有效病例4周后确认。部分患者并辅助局部姑息放疗及内分泌治疗。结果全组46例,完全缓解(CR)5例(10.87%),部分缓解(PR)22例(47.83%),稳定(SD)15例(32.61%),进展(PD)4例(8.70%),总有效率58.70%(27/46)。TP方案有效率56.52%,TC方案有效率60.87%(P>0.05)。中位缓解期9.2个月,中位生存期19.2个月(范围:6.2个月至44.8个月),1年、2年和3年生存率分别为70.45%,34.01%,17.01%。主要不良反应为脱发、肌肉关节痛、消化道毒性、骨髓抑制和手足综合征。结论两组以紫杉醇为主的联合方案治疗蒽环类耐药的晚期乳腺癌均有较好疗效,不良反应可耐受,近期疗效差异无统计学意义。Objective To investigate the efficacy and toxicity of paclitexal-based combination chemotherapy in the treatment of patients with anthraeyeline-resistant advanced breast cancer. Methods Of 46 patients with anthracycline-resistant advanced breast cancer, 23 cases received the paclitaxel 135-175 mg/m^2 by 3-hour continuous infusion on dl plus cisplatin 80 mg/m^2 infusion on d2-4 （TP）;Tbe others received the paclitaxel plus capec itabine 1250-1650 mg/（m^2.d）, po, bid, d 1-14（TC）.The regimen was repeated every 21 days and the clinical response was assessed after three cycles, the effective cases were confimed after 4 weeks. The radiotherapy and the endocrine treatment were selected for some patients. Resealts In 46 patients there were 5 complete response and 22 partial response. The overall response rate was 58.70%（27/46）.TP combined chemotherapy was 56.52%,TC combined chemotherapy was 60.87%（P〉0.05）.The median time to remisson was 9.2 months, the median survival time was 19.2 months（range：6.2-44.8 months）, and 1-,2-,3-year survival rates were 70.45%,34.01%, 17.01%. The major side effects were alopecia,myalgia,anthraligia,GI discomfort,myelosuppression and hand-foot syndrome. Conclusion Combinations of TP and TC has good therapeutic effectiveness for patients with anthracycline-resistant advanced breast cancer. And the side effects were tolerable. There is no significant difference between objective responses of two regimens.

关 键 词：紫杉醇 顺铂 卡培他滨 联合化疗 晚期乳腺癌 

分 类 号：R737.9[医药卫生—肿瘤]