长春瑞滨联合表阿霉素治疗乳腺癌  

Vinorelbine epirubcin combination chemotherapy for brest cancer

作　　者：王天峰[1] 刘淑俊[1] 张力建[1] 宋恕平[2] 祝浩强[3] 唐桂棣[3] 徐农[4] 张沂平[4] 崔树德[5] 张京泰[1] 徐光炜[1] 

机构地区：[1]北京医科大学临床肿瘤学院外科,北京100036 [2]山东省肿瘤医院,山东济南250001 [3]江苏省肿瘤医院,江苏南京210009 [4]浙江省肿瘤医院,浙江杭州3100266 [5]河南省肿瘤医院,河南郑州450006

出　　处：《中国癌症杂志》2000年第3期219-221,共3页China Oncology

摘　　要：目的 :评价长春瑞滨联合表阿霉素治疗乳腺癌的疗效和毒副反应。方法 :多中心前瞻性临床研究。乳腺癌患者 5 9例 ,应用长春瑞滨 2 5mg/m2 d1、d5静滴 ,表阿霉素 70mg/m2 d1静注 ,每 2 8d为 1周期 ,每个患者 2周期。静注恩丹西酮±地塞米松预防呕吐。结果 :全组总缓解率 (OR) 6 9 5 % ,其中完全缓解率 (CR) 8 5 %。初次化疗患者OR 76 7% ,CR 13 3% ;再次化疗患者OR 6 2 1% ,CR 3 5 %。乳腺原发灶OR 77 4% ,CR 16 1% ;转移灶OR6 1 3% ,CR 6 5 % ,其中腋窝淋巴结转移灶OR 6 8 0 % ,CR 8 0 % ;肝、肺转移灶各部分缓解 (PR) 5 0 0 %。毒副反应以白细胞低下和呕吐最为常见 ,其发生率分别为 95 8%和 87 3 %。其中Ⅲ°和Ⅳ°白细胞低下发生率分别高达37 3%和 17 0 % ,Ⅲ°和Ⅳ°中性粒细胞低下的发生率分为 18 6 %和 19 5 % ,32例患者需治疗性应用粒细胞集落刺激因子。Ⅲ°血小板低下和贫血的发生率分别为 5 9%和 2 5 %。Ⅲ°脱发的发生率为 14 4% ,Ⅳ°便秘的发生率为0 8%。结论 :长春瑞滨联合表阿霉素化疗对初治与复发乳腺癌均有较高疗效 ,但其重度骨髓抑制发生率较高 。Purpose:To evaluate the efficacy and toxicity of vinorelbine epirubicin combination chemotherapy for breast cancer.Methods:Fifty nine women with breast cancer were included in this multi center prospective study. Vinorelbine was given 25 mg/m 2 introvenously on d1 and d5, and epirubicin 70 mg/m 2 intraovenously on d1 of each cycle, 28 days a cycle, 2 cycles per patient. Antiemetic prophylacitic treatment consisted of ondanseton with or without dexamethasone introvenousely. Results:The overal response rate (OR) for the whole group of patients was 69.5% with 8.5% complete response (CR). In the first time chemotherapy naive patients, the OR was 76.7% with 13.3% CR; while in those with prior chemotherapy, an OR as high as 62.1% with 3.5% CR was also obtained. For primary tumors of the breast, an OR of 77.4% and a CR of 16.1% were documented, and the metastatic lesions also responded well with 61.3% OR and 6.5% CR. Among the secondery lesions, an OR of 68.5% with 8.0% CR for the axillary lymph nodes and two 50.0% PRs each for metastases in the liver and the lung, respectively,were found. The most commonly seen adverse affects of the regimen were leukopenia and vomiting,with frequencies of 95.8% and 87.3%, respectvely. Notably,frequency of leukopenia of Ⅲ° and Ⅳ° was as high as 37.3% and 17.0%, respectively, and neutropenia 18.6% and 19.5%, respectvely. Thirty two cases needed therapeutic granulocyte colony stimulating factor administration.Thrombocytopenia and anemia of Ⅲ° only occurred in 3.9% and 2.5% of cycles, respectively, and Ⅳ° constipation in 0.8% cycles. Conclusions:Vinorelbine epirubicin combinaition chemotherapy is highly active both as a first line and as a second line regimen for breast cancer. Severe bone marrow suppression is rather common with this therapy and deserves considerable attention.

关 键 词：乳腺癌 长春瑞滨 联合用药 表阿霉素 

分 类 号：R737.905[医药卫生—肿瘤] R730.53[医药卫生—临床医学]