培美曲塞联合顺铂方案治疗蒽环类及紫杉类治疗失败的晚期转移性乳腺癌的初步研究  

Preliminary observation of pemetrexed combined with cisplatin in the treatment after the treatment failure of anthracycline and taxane in advanced metastatic breast cancer

作　　者：张玺炜[1] 高洪元[1] 储冬英[1] 赵子仪[1] 

机构地区：[1]上海市静安区中心医院肿瘤科,上海200040

出　　处：《中国癌症杂志》2009年第9期697-700,共4页China Oncology

摘　　要：背景与目的:对转移性乳腺癌目前在治疗上仍是一个难点,对于使用蒽环类和紫杉类失败的晚期转移性乳腺癌患者,治疗方案的选择非常有限。本研究通过观察培美曲塞联合顺铂治疗蒽环类及紫杉类治疗失败的晚期转移性乳腺癌的疗效及不良反应,以期为晚期转移性乳腺癌的治疗提供新的思路和方法。方法:10例晚期转移性乳腺癌患者接受培美曲塞联合顺铂化疗方案。培美曲塞500mg/m2,顺铂75mg/m2,静脉滴注,每3周重复。每2个疗程评价1次疗效、不良反应和疾病缓解率以及生活质量评估,计算疾病进展时间(TTP)和总生存期(OS)。结果:10例患者均可评价疗效,其中CR1例,PR4例,SD2例,PD3例。中位随访时间为6个月(4～18个月),8例存活,2例死亡,中位TTP为4个月(3～14个月),中位生存期(overall survival,OS)8个月(4～18个月)。Cox回归分析显示OS的预测因素是ECOG评分;TTP的预测因素包括ECOG评分和化疗疗效;最常见的不良反应是疲乏、白细胞减低和消化道反应,其次为口腔溃疡。结论:培美曲塞联合顺铂方案治疗蒽环类及紫杉类治疗失败的晚期转移性乳腺癌能够提高患者的生存率,不良反应较轻可以耐受,当患者对多种化疗药物产生耐药性时,该药是可选之药。Background and purpose： At present, the treatment of metastatic breast cancer has remained difficult for patients who have failed after the use of anthracyeline and taxane, so the treatment options for those with advanced metastatic breast cancer are very limited. Therefore, pemetrexed combined with cisplatin in the treatment of anthracycline and taxane failed advanced metastatic breast cancer patients, its efficacy and adverse reactions were studied. Methods： 10 patients with advanced metastatic breast cancer patients received pemetrexed and cisplatin chemotherapy, pemetrexed 500 mg/m^2 intravenous infusion, cisplatin 75 mg/m^2 intravenous drip, repeated every 3 weeks. Evaluation of response and adverse reactions were practiced every 2 cycles. Results： 10 patients were evaluable, CR 1 patient, PR 4 patients, SD 2 patients, PD 3 patients. With a median follow-up of 6 months （4-18 months）, 8 patients survived and 2 patients died. The median time to progression was 4 months （3-14 months）, the median survival time was 8 months （4-18 months）. The most common adverse reaction was fatigue, white blood cells decrease and the digestive tract reactions, followed by oral ulcers. Conclusion： Pemetrexed combined with cisplatin in the treatment of anthracycline and taxane treatment failed patients with advanced metastatic breast cancer could improve survival, adverse reactions could be tolerated.

关 键 词：培美曲塞 顺铂 转移性乳腺癌 

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