紫杉醇或吉西他滨联合顺铂治疗蒽环类耐药晚期乳腺癌患者临床疗效及安全性观察  

Efficacy and safety of paclitaxel or gemcitabine combined with cisplatin in the treatment of anthracycline-resistant advanced breast cancer

作　　者：乔雪 李士猛 杨红梅 QIAO Xue;U Shi-meng;YANG Hong-mei(Department of Oncology,Central Hospital of Shuyang County,Suqian 223600,China;Department of Oncology,The First People's Hospital of Suqian,Suqian 223800,China)

机构地区：[1]江苏省宿迁市沐阳县中心医院肿瘤内科,宿迁223600 [2]宿迁市第一人民医院肿瘤科,宿迁223800

出　　处：《中国肿瘤临床与康复》2019年第12期1478-1481,共4页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨紫杉醇联合顺铂(TP方案)与吉西他滨联合顺铂(GP方案)治疗蒽环类耐药晚期乳腺癌患者的临床疗效及安全性。方法选取2015年8月至2018年10月间宿迁市沭阳县中心医院收治的96例晚期乳腺癌患者,根据治疗方法不同分为紫杉醇组与吉西他滨组,每组48例。紫杉醇组患者采用紫杉醇联合顺铂治疗,吉西他滨组患者采用吉西他滨联合顺铂化疗,比较两组患者的近期临床疗效及不良反应。结果紫杉醇组患者总有效率为50.0%,吉西他滨组为39.6%,两组比较,差异无统计学意义(P>0.05)。两组患者白细胞减少发生率比较,差异无统计学意义,但吉西他滨组患者Ⅲ度白细胞减少发生率更高,差异有统计学意义(P<0.05);吉西他滨组患者血小板减少发生率高于紫杉醇组,差异有统计学意义(P<0.05);紫杉醇组患者血红蛋白下降和脱发发生率均高于吉西他滨组,差异均有统计学意义(均P<0.05)。两组患者过敏反应、肝肾功能损害和神经毒性发生率比较,差异无统计学意义(P>0.05)。两组患者恶心呕吐严重程度主要为Ⅰ度与Ⅱ度,差异无统计学意义(P>0.05)。结论紫杉醇或吉西他滨联合顺铂治疗蒽环类耐药晚期乳腺癌患者,近期临床疗效相似。吉西他滨不良反应主要为白细胞减少、血小板减少、恶心呕吐,紫杉醇不良反应主要为白细胞减少、血红蛋白下降、恶心呕吐、脱发。Objective To compare the efficacy and safety of taxol combined with cisplatin(TP regimen)and gemcitabine combined with cisplatin(GP regimen)in the treatment of anthracycline-resistant advanced breast cancer.Methods Ninety-six patients with advanced breast cancer diagnosed and treated at Central Hospital of Shuyang County from August 2015 to October 2018 were selected and randomly divided into a paclitaxel group and a gemcitabine group with 48 patients in each group.The paclitaxel group was treated with paclitaxel combined with cisplatin,and the gemcitabine group was treated with gemcitabine combined with cisplatin.The short-term clinical efficacy and adverse reactions were compared between the two groups.Results The overall efficacy was 50.0%in the paclitaxel group and 39.6%in the gemcitabine group(P>0.05).There was no significant difference in the incidence of leukocytopenia between the two groups(P>0.05).However,the incidence of gradeⅢleukocytopenia was higher in the gemcitabine group than in the paclitaxel group(P<0.05).The incidence of thrombocytopenia was higher in the gemcitabine group than in the paclitaxel group(P<0.05).The incidence of hemoglobin decrease and hair loss was higher in the paclitaxel group than in the gemcitabine group(P<0.05).There was no significant difference in the incidence of allergic reaction,liver and kidney failure and neurotoxicity between the two groups(P>0.05).Nausea and vomiting of gradeⅠandⅡoccurred in the two groups and there was no significant difference between the two groups(P>0.05).Conclusion The short-term clinical efficacy of paclitaxel or gemcitabine combined with cisplatin in the treatment of anthracycline-resistant advanced breast cancer is similar.The adverse reactions mainly included leukopenia,thrombocytopenia and nausea and vomiting for the gemcitabine group and leukopenia,hemoglobin decline,nausea and vomiting and hair loss for the paclitaxel group.

关 键 词：紫杉醇 吉西他滨 顺铂 蒽环类 耐药 晚期 乳腺肿瘤 

分 类 号：R737.4[医药卫生—肿瘤]