NP方案与GX方案二线治疗晚期乳腺癌的临床对比观察  

Clinical observation on NP and GX regimens in the treatment of advanced breast cancer

作　　者：裘光贤 周兆春 石阳[1] 崔舒晟[1] 

机构地区：[1]上海市黄浦区中心医院肿瘤科,200002

出　　处：《肿瘤研究与临床》2012年第12期809-812,共4页Cancer Research and Clinic

摘　　要：目的比较长春瑞滨联合顺铂（NP）方案和吉西他滨联合卡培他滨（GX）方案二线治疗葸环类和（或）紫杉类耐药晚期乳腺癌患者的疗效和不良反应。方法75例晚期乳腺癌患者按信封法随机分为两组，其中NP组40例，GX组35例。NP方案：长春瑞滨25mg／m^2，静脉滴注，第1、8天；顺铂25mg／m^2，静脉滴注，第1天至第3天；21d为1个周期。GX方案：吉西他滨1000mg／m。，静脉滴注，第1、8天；卡培他滨2500mg／m^2，分2次口服，第l天至第14天；21d为1个周期，2个周期后评价疗效和不良反应。结果NP组和GX组总有效率分别为42.5％（17／40）和40．0％（14／35），中位疾病进展时间分别为7．0和6．5个月，中位生存期分别为15．8和15．0个月，1、2年生存率分别为60．0％、32．5％和57.l％314％，Karnofsky评分提高率分别为50．0％（20／40）和42．9％（15／35）。以上差异均无统计学意义（均P〉O．05）。两组主要不良反应为骨髓抑制、消化道反应，其中GX组的手足综合征发生率明显高于NP组[29％（10／35）比0]，消化道反应NP组明显高于GX组[95％（38／40）比26％（9／35）]，差异均有统计学意义（均P〈0．05）。结论NP方案与GX方案对晚期乳腺癌患者均有较好疗效，且不良反应均可耐受，可作为蒽环类、紫杉类药物治疗失败的晚期乳腺癌患者解救方案。Objective To observe the efficacy and adverse reaction of NP and GX regimens in the treatment of the anthraeycline-and-taxane-resistant advanced breast cancer. Methods Totally 75 patients with advanced breast cancer were divided into two groups, and received NP or GX regimen. NP group （n = 40）： NVB 25 mg/m2, day 1, day 8, iv.drip; DDP 25 mg/m2, day 1-3, iv.drip. GX group （n = 35）： GEM 1000 mg/m2 day 1, day 8, iv.drip; XEL 2500 mg/m2, day 1-14, bid po. Every 21 days was a cycle. The efficacy and adverse reaction were evaluated after two cycles. Results The overall response rates in the NP and GX group were 42.5 % （17/40） and 40.0 % （14/35）. The median TI＇P of two group were 7 and 6.5 months. The MST was 15.8 and 15.0 months in the NP and GX group. The 1- and 2-year survival rates were 60.0 %, 32.5 % and 57,1%, 31.4 %. The increase ratio of Karnofsky were 50.0 % and 42.9 %. There were not significant difference between the two groups in terms of their treatment response （P 〉 0.05）. The main adverse reactions in ttt~ two group were myelosuppression, gastrointestinal reaction and phlebitis. Hand-foot syndrome in GX was significantly higher than that in NP group, Gastrointestinal reactions in NP was significantly higher than that in GX group （P 〈 0.05）. Conclusion NP and GX regimens are effective for patients with metastatic breast cancer, their adverse reactions are tolerable,so they can be regarded as a hermate regimens for anthracyelines and taxanes resistant patients with metastatic breast cancer.

关 键 词：乳腺肿瘤 药物疗法 联合 长春瑞滨 顺铂 吉西他滨 卡培他滨 

分 类 号：R737.9[医药卫生—肿瘤]