奥沙利铂联合替吉奥治疗难治性晚期乳腺癌临床观察

doi:10.3760/cma.j.issn.1673-422X.2016.05.003

摘要/Abstract

摘要： 目的评价奥沙利铂联合替吉奥治疗难治性晚期乳腺癌的疗效和不良反应。方法选择72例经病理证实已经接受分别以紫杉类、蒽环类为主的化疗方案治疗失败的晚期乳腺癌患者，予多周期奥沙利铂联合替吉奥方案化疗：第1天予奥沙利铂，135 mg/m2，加入5％葡萄糖注射液500 ml中，静脉滴注不少于2 h完成；每天早、晚饭后口服替吉奥胶囊共40~60 mg，连服14 d，停用7 d，两药均21 d重复；每2周期评价疗效，有效及稳定患者继续化疗，最长不超过6周期。结果乳腺癌患者完全缓解2例（2.8%），部分缓解26例（36.1%），客观有效率为38.9%，疾病控制率为69.4%。患者中位无进展生存期为7.7个月，中位总生存期为12.3个月。亚组分析显示，Ⅳ期、2个及以上部位转移、既往使用紫杉类、蒽环类化疗后仍然进展的患者中位总生存期分别明显短于ⅢC期、1个部位转移、既往化疗有效及稳定的患者，差异有统计学意义（10.5个月∶15.0个月，χ2=4.469，P=0.035；9.3个月∶15.0个月，χ2=8.297，P=0.004；10.0个月∶14.0个月，χ2=4.077，P=0.043）。Ⅲ~Ⅳ级不良反应包括中性粒细胞减少（19.4％）、恶心呕吐（8.3％）和外周神经毒性（2.8％）；腹泻、肝功能损害、口腔炎、贫血和手足综合征等多为Ⅰ~Ⅱ级。结论奥沙利铂联合替吉奥治疗难治性晚期乳腺癌安全、有效，并且不良反应可以耐受。

关键词: 乳腺肿瘤, 肿瘤转移, 药物疗法

Abstract: ObjectiveTo evaluate the efficacy and toxicity of the combination of oxaliplatin and S1 in the treatment of patients with advanced breast cancer. MethodsA total of 72 patients with advanced breast cancer after the treatment failuer of anthracycline and taxane were treated with oxaliplatin and S1. The first day, they were given oxaliplatin, 135 mg/m2, with the 5% glucose injection 500 ml, the time of intravenous drip should be more than 2 hours. And the S1 was taken after breakfast and dinner, the dose was 4060 mg, and the time of duration was 2 weeks, then they had 7 days to rest. The cycle was 21 days. Every 2 cycles, we estimated the efficacy. Patients who were effective and stable kept that chemotherapy regimens, the maximum duration was 6 cycles. The efficacy and toxicities were evaluated after cycles of chemotherapy. ResultsTwo cases (2.8%) had complete response (CR), 26 cases (36.1%) had partial response (PR). The response rate (RR) was 38.9% and the disease control rate (DCR) was 69.4%. The median progress free survival (PFS) was 7.7 months and the median overall survival (OS) was 12.3 months. Subgroup analysis showed that the OS of patients who belong to stage Ⅳ, had two or more metastases or with failure treatment after being treated with anthracycline and taxane was notably shorter than the patients who belong to stage ⅢC, only one metastasis, with effective treatment after being treated with anthracycline and taxane, and the differences were statistically significant (10.5 months vs. 15.0 months, χ2=4.469, P=0.035; 9.3 months vs. 15.0 months, χ2=8.297, P=0.004; 10.0 months vs. 14.0 months, χ2=4.077, P=0.043). The main side effects were neutropenia (19.4%), nausea (8.3%) and nerve toxicity (2.8%), mainly 34 degree, and could be welltolerated. The others were diarrhea, impaired liver function, stomatitis, anemia and handfoot syndrome, mainly 12 degree. ConclusionOxaliplatin combined with S1 is effective and tolerable in treatment of patients with advanced breast cancer, the adverse reactions can be tolerated.

Key words: Breast neoplasms, Neoplasms metastasis, Drug therapy

刘君,肖扬,马益慧,郭建雄,刘阳晨,黄小红,张荣侠. 奥沙利铂联合替吉奥治疗难治性晚期乳腺癌临床观察[J]. 国际肿瘤学杂志, 2016, 43(5): 330-334.

Liu Jun, Xiao Yang, Ma Yihui, Guo Jianxiong, Liu Yangchen, Huang Xiaohong, Zhang Rongxia. Clinical observation of oxaliplatin combined with S-1 on the patients with advanced breast cancer[J]. Journal of International Oncology, 2016, 43(5): 330-334.

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