伊立替康单药三线及以上治疗晚期乳腺癌的有效性和安全性研究  

Efficacy and Safety of Irinotecan in the Third-line and Above Treatment of Advanced Breast Cancer

作　　者：贾思思 孟娜娜 周林静 何秋立 韩丽娟 张桂芳 JIA Sisi;MENG Nana;ZHOU Linjing;HE Qiuli;HAN Lijuan;ZHANG Guifang(Xinxiang Central Hospital/Fourth Clinical College of Xinxiang Medical College,Xinxiang 453000,Henan,China)

机构地区：[1]新乡市中心医院/新乡医学院第四临床学院,河南新乡453000

出　　处：《中国药物滥用防治杂志》2022年第10期1482-1485,共4页Chinese Journal of Drug Abuse Prevention and Treatment

摘　　要：目的:探讨伊立替康单药三线及以上治疗晚期乳腺癌的有效性和安全性。方法:收集2018年1月—2020年11月我院收治的晚期乳腺癌患者60例,既往均接受紫杉烷类和蒽环类治疗,且治疗方案≥2种,伊立替康单药治疗至发生不可耐受的毒副反应或疾病进展。每2周期评价疗效,并评价毒副反应。结果:截至2020年11月,19例患者仍生存,41例患者死亡,其中4例患者治疗未结束。随访时间2~30个月,中位随访8.4个月。60例患者总计化疗194周期,疾病控制率(DCR)为21.67%(13/60),客观缓解率(ORR)为1.67%(1/60)。全部60例患者中位无进展生存期(PFS)为77d,中位总生存期(OS)为301d。治疗期间Ⅰ/Ⅱ级不良反应分别为恶心33.33%,乏力25.00%,呕吐13.33%,贫血35%,腹泻16.67%,血小板减少3.33%,中性粒细胞减少33.33%;Ⅲ级不良反应以腹泻和中性粒细胞减少为主,均为10.00%,贫血、呕吐分别为3.33%,恶心为1.67%;未发生Ⅳ级不良反应及治疗相关性死亡。结论:伊立替康单药三线及三线以上治疗晚期乳腺癌的疗效尚可,能增加生存获益,患者耐受性良好。Objective: To investigate the efficacy and safety of irinotecan single agent third line and beyond for the treatment of advanced breast cancer. Method: A total of 60 advanced breast cancer patients treated in our hospital from January 2018 to November 2020, all of whom were previously treated with taxanes and anthracyclines and had ≥ 2 treatment regimens, and irinotecan monotherapy until the occurrence of intolerable toxic effects or disease progression. Efficacy was assessed every 2cycles, and toxicities were assessed.Result: As of November 2020, 19 patients were still alive, 41 patients died, and 4 of them were not completed. The follow-up time was 2-30 months, with a median follow-up of 8.4 months. The disease control rate(DCR) was 21.67%, and the objective response rate(ORR) was 1.67%. The median progression-free survival(PFS) of all 60patients was 77 days, and the median overall survival(OS) was 301 days. Grade I/II adverse reactions during treatment were nausea 33.33%, fatigue 25.00%, vomiting 13.33%, anemia 35%, diarrhea 16.67%, thrombocytopenia 3.33%, neutropenia 33.33%. Grade Ⅲ adverse reactions were mainly diarrhea and neutropenia, both of which were 10.00%, anemia and vomiting were 3.33%, and nausea was 1.67%. No grade IV adverse reactions and treatment-related death occurred. Conclusion: The efficacy of irinotecan monotherapy as third-line and above in the treatment of advanced breast cancer is acceptable, which can increase survival benefit and is well tolerated.

关 键 词：晚期乳腺癌 伊立替康 单药化疗 疗效 毒副反应 

分 类 号：R737.9[医药卫生—肿瘤]