吉西他滨联合长春瑞滨治疗晚期三阴性乳腺癌的临床观察  

The study of gemcitabine plus vinorelbine in the patients with triple-negative metastatic breast cancer

作　　者：杨晨[1] 姚阳[1] 赵晖[1] 

机构地区：[1]上海市第六人民医院肿瘤内科,上海200233

出　　处：《临床肿瘤学杂志》2009年第5期425-428,共4页Chinese Clinical Oncology

摘　　要：目的:观察吉西他滨联合长春瑞滨(GN方案)治疗ER、PR、HER-2均阴性(三阴性)晚期转移性乳腺癌的疗效与安全性。方法:2004年1月～2008年1月共37例经免疫组化证实ER、PR、HER-2均阴性的晚期转移性乳腺癌复治患者参与研究。患者接受吉西他滨联合长春瑞滨方案治疗:吉西他滨1 000mg/m2,静脉滴注30min,d1、d8;长春瑞滨25mg/m2静脉滴注15min,d1、d8。21天重复。结果:全组37例共完成136个周期的治疗,中位数4个周期,范围2～6个周期,均可评价疗效。完全缓解1例(2.7%),部分缓解8例(21.6%),病情稳定20例(51.4%),病情进展9例(21.6%),客观有效率为24.3%;中位疾病进展时间(mTTP)6个月(95%CI:4～8个月),中位生存期(OS)24个月(95%CI:11～37个月),1年生存率为(66.24±8.43)%,3年生存率为(28.77±11.96)%。毒副反应主要为Ⅰ～Ⅱ度骨髓抑制、末梢神经毒性、胃肠道反应、流感样症状、轻度肝功能损伤等。结论:吉西他滨联合长春瑞滨治疗晚期三阴性乳腺癌患者,初步观察有一定的疗效,其毒副作用患者可以耐受。Objective ： Estrogen receptor（ ER）, progesterone receptor （ PR）, human epidermal growth factor receptor 2 （ HER- 2） triple-negative advanced breast carcinoma（TNABC） is not sensitve to hormone therapy. The aim of this study was to evaluate the anti-tumor activity and safety of gemcitabine and vinorelbine in patients with advanced TNABC who had been treated with chemotherapy. Methods：Thirty-seven patients with immunohistochemical proved TNABC were enrolled. The patients received 21 days per cycle of vinorelbine 25 mg/m^2 and gemcitabine 1 000mg/m^2 on d1, d8. Resnlts：A total of 136 cycles were given to 37 patients （median 4;rang 2-6 cycles）. The treatment response is evaluable in all patients. Of the 37 patients, 1 received complete remission（ CR）, 8 received partial remission（PR） ,20 had stable diease（SD） ,9 had progressive diease（PD）. Response rates（ CR ＋ PR） were 24. 3%. The median time to progress（TTP） was 6 months （95% CI：4-8）. The median overall survlal was 24 months（95% CI：11-37）. The median 1-year survial rate was （ 66. 24 ± 8.43 ） %. The median 3-year survial rate was （ 28. 77 ± 11.96） %. The major adverse events were grade Ⅰ - Ⅱ myelosuppression, peripheral neurologic toxicities, nausea and vomiting. Some patients had rash and hepatic dysfunction. A total of 40% of patients experienced flu-like symptoms. Alopecia and diarrhea were rare. Conclusion：The combination of gemcitabine and vinorelbine is an effective and well tolerated regimen for the patients with TNABC.

关 键 词：吉西他滨 长春瑞滨 乳腺癌 化学治疗 

分 类 号：R737.9[医药卫生—肿瘤] R730.53[医药卫生—临床医学]