多西紫杉醇与紫杉醇联合吡柔比星和环磷酰胺在局部进展期乳腺癌化疗中致心脏毒性的观察  

Contrast Observation of Cardiotoxicity in Chemotherapy of Locally Advanced Breast Cancer with Docetaxel Versus Paclitaxel Plus Pirarubicin Hydrochloride and Cyclophosphamide

作　　者：韩江琼[1,2] 陈云兰[1,2] 胡跃红[1,2] 周永春[1,2] 

机构地区：[1]云南省肿瘤医院 [2]昆明医科大学第三附属医院,云南昆明650118

出　　处：《昆明医科大学学报》2013年第3期76-78,共3页Journal of Kunming Medical University

基　　金：云南省科技厅应用基础研究基金项目资助(2010CD081)

摘　　要：目的比较多西紫杉醇及紫杉醇联合吡柔比星(THP)和环磷酰胺(CTX)的化疗方案治疗局部进展期乳腺癌致心脏毒性的反应.方法 83例局部进展期乳腺癌患者随机分成A组42例给予多西紫杉醇75mg/m2+THP 40 mg/m2+CTX 600 mg/m2;B组41例给予紫杉醇175 mg/m2+THP 40 mg/m2+CTX 600 mg/m2进行治疗4疗程监测其24 h动态心电图(DCG)进行统计分析.结果 DCG监测相关心脏毒性效应的心律失常、ST-T改变发生率A、B两组分别为:第1疗程前的4.76%、4.87%及第2疗程前的7.14%、9.75%差异无统计学意义(P>0.05);第3疗程前的16.66%、41.46%及第4疗程后的30.95%、68.29%差异有统计学意义(P<0.05).结论多西紫杉醇+THP+CTX的化疗方案致心脏毒性的作用小于紫杉+THP+CTX的化疗方案,就其对心脏副作用小方面值得在临床推广.Objective To compare the cardiotoxicity in chemotherapy of locally advanced breast cancer（LABC） with docetaxel versus paclitaxel plus pirarubicin hydrochloride and cyclophosphamide.Methods Eighty-three patients with LABC were randomly assigned to group A（42 cases） and group B（41 cases） for treatment.Group A was given docetaxel 75 mg/m2＋ THP 40 mg/m2＋ CTX 600 mg/m2,and group B was treated with paclitaxel 175 mg/m2 ＋ THP40 mg/m2 ＋ CTX 600 mg/m2.24 h dynamic electrocardiogram（DCG） was monitored during four courses for statistical analysis.Results The incidences of arrhythmia and ST-T change for groups A and B were 4.76% and 4.87% before the first course of treatment and 7.14% and 9.75% before the second course,respectively.There was no significant difference before and after treatment.However,compared with the incidences of 16.66% and 41.46% before the third course,the incidences of arrhythmia and ST-T change for groups A and B before the fourth course of treatment were 30.95% and 68.29%,with statistically significant difference（P 0.05）.Conclusion Compared with paclitaxel,the combined regimen of docetaxel plus THP and CTX induced less cardiotoxicity for locally advanced breast cancer.The chemotherapy regiment was worth spreading in the clinic.

关 键 词：局部进展期乳腺癌 心脏毒性 动态心电图 

分 类 号：R737.9[医药卫生—肿瘤]