卡培他滨为主的联合方案治疗晚期转移性乳腺癌  

Capecitabine-based combination chemotherapy for metastatic breast cancer

作　　者：恽蓓 孙国荣[2] 

机构地区：[1]上海浦东新区公利医院普通外科,上海200135 [2]上海同济大学附属东方医院普通外科,上海200120

出　　处：《中国普通外科杂志》2011年第11期1179-1183,共5页China Journal of General Surgery

摘　　要：目的探讨以卡培他滨(希罗达)为主的联合化疗方案治疗转移性乳腺癌的临床效果及毒副反应。方法 42例转移性乳腺癌患者中,23例为既往使用蒽环类治疗失败,给予希罗达联合诺维本治疗(诺维本25 mg/m2,化疗周期的第1天及第8天各静脉滴注1次;希罗达2 000 mg/m2,口服,2次/d,服用2周,每3周为1个周期);1 9例既往未曾采用蒽环类治疗,给予希罗达联合吡柔比星(吡柔比星35 mg/m2,化疗周期的第1天及第8天各静脉滴注1次;口服希罗达,剂量、用法疗程同上)。所有患者至少接受化疗6周期后方可评价疗效。结果希罗达联合诺维本组完全缓解(CR)5例,部分缓解(PR)12例,稳定(SD)4例,进展(PD)2例;有效率为73.91%(17/23);中位疾病进展时间(TTP)为8.4个月,中位生存期(MST)为18.1个月。希罗达联合吡柔比星组CR 5例,PR 7例,SD2例,PD 5例;有效率为6 3.1 6%(1 2/1 9);TTP为个7.8个月,MST为17.5个月。两组之间化疗有效率无明显差异(P>0.05)。两组主要毒副反应为白细胞减少,其中III～IV度占52.4%;手足综合征II～III级者占1 9.0%。结论卡培他滨为主的联合化疗方案治疗转移性乳腺癌效果确切,毒性反应可耐受。Objective To investigate the efficacy and toxicity of capecitabine （Xeloda） -based combination chemotherapy for metastatic breast cancer （ MBC ）. Methods Of the 42 MBC patients, 23 cases who had failed previous anthracycline-based chemotherapy received a regimen of Xeloda plus navelbine （treatment schedule ： navelbine 25 mg/m2 iv. on day 1 and day 8, Xeloda 2000 mg/m2 po. twice daily from day 1 to day 14 every 3 weeks）; the other 19 cases who had no prior anthracycline-based chemotherapy received Xeloda plus pirarubicin （treatment schedule： pirarubicin 35 mg/m2 iv. on day 1 and day 8, Xeloda with the same dosage regimen and treatment course as above-mentioned ）. The efficacy was assessed after at least 6 cycles of chemotherapy in all patients. Results Of the patients who received Xeloda plus navelbine, complete response （CR） was achieved in 5 cases, partial response （PR） in 12 cases and stable disease （SD） in 4 patients, and progressive disease （PD） was observed in 2 patients; the response rate was 73.91% （17/23）; the median time to progression （TTP） was 8. 4 months, and median survival time （MST） was 18. 1 months. Of the patients who received Xeloda plus pirarubicin, the cases of CR, PR, SD and PD were 5, 7, 2 and 5, respectively; the response rate was 63. 16% （12/19） ; TFP and MST was 7.8 and 17. 5 months, respectively. The effective rate between the two sets of schedules showed no significant difference （ P 〉 0.05 ）. The major toxicity and adverse events for all the patients were leukopeuia （Grade Ill-IV in 52. 4% patients ） and hand-foot syndrome （Grade Ⅱ-Ⅲ in 19. 0% patients ）. Conclusions Capecitabine-based combination chemotherapy has substantial efficacy for MBC with tolerable toxicity profiles.

关 键 词：乳腺肿瘤/药物疗法 卡培他滨 诺维本 吡柔比星 转移性乳腺癌 

分 类 号：R737.9[医药卫生—肿瘤]