多西他赛联合卡培他滨一线治疗转移性乳腺癌的临床疗效和不良反应

doi:10.3760/cma.j.issn.1673-422X.2017.06.006

摘要/Abstract

摘要： 目的探讨多西他赛联合卡培他滨一线治疗转移性乳腺癌的临床疗效及不良反应，并分析其在转移性乳腺癌不同分子分型中的疗效。方法回顾性分析北京市朝阳区三环肿瘤医院2012年1月1日至2015年12月31日多西他赛联合卡培他滨一线治疗转移性乳腺癌患者108例，可评价病例104例，分析其临床特点及疗效、不良反应等。结果104例患者分为Luminal型85例，三阴型14例，人类表皮生长因子受体2（HER2）过表达型5例。近期疗效：完全缓解（CR）4例，部分缓解（PR）51例，疾病稳定（SD）37例，疾病进展（PD）12例，客观缓解率为52.9%，疾病控制率为88.5%；其中Luminal型CR 4例，PR 43例，SD 33例，PD 5例；三阴型PR 6例，SD 3例，PD 5例；HER2过表达型PR 2例，SD 1例，PD 2例，不同分子分型近期疗效比较差异无统计学意义（χ2=4.429，P=0.106）。104例患者无进展生存期（PFS）为1.5～121.0个月，中位PFS为10.0个月，其中Luminal型患者的中位PFS为11.0个月，三阴型为4.0个月，HER2过表达型为10.3个月，差异具有统计学意义（χ2=7.510，P=0.006）。常见不良反应为手足综合征、恶心或呕吐、粒细胞下降、贫血、腹泻等。2、3级手足综合征发生率为44.2%（46/104），3、4级粒细胞下降发生率为39.4%（41/104）。结论多西他赛联合卡培他滨一线治疗转移性乳腺癌疗效确切，不良反应可耐受，其中Luminal型获益显著。

关键词: 乳腺肿瘤, 肿瘤转移, 药物疗法, 分子分型

Abstract: ObjectiveTo evaluate the clinical value and toxicities of docetaxel plus capecitabine in the firstline treatment of metastatic breast cancer (MBC), and compare the outcomes among different molecular subtypes. MethodsA total of 108 patients with MBC who received docetaxel plus capecitabine combination treatment between January 1， 2012 and December 31， 2015 in Bejing Chaoyang District Sanhuan Cancer Hospital were retrospectively analyzed, and 104 cases were available for evaluation. The clinicopathological characteristics, clinical value and toxicities of these patients were evaluated. ResultsThe patients were divided into 3 molecular subtypes, among 104 patients, 85 patients in Luminal subtype, 14 patients in triple negative breast cancer (TNBC) subtype, and 5 patients in human epidermal growth factor receptor2 (HER2) over expression subtype. The treatment achieved objective responses (OR) in 55 patients (52.9%), and the disease control rate (DCR) was 88.5%, including complete response (CR) in 4 patients, partial response (PR) in 51 patients, stable disease (SD) in 37 patients, and progressive disease (PD) in 12 patients. In Luminal subtype, 4 patients achieved CR, 43 PR, 33 SD, and 5 PD. In TNBC subtype, 6 patients achieved PR, 3 SD, 5 PD. In the HER2 over expression subtype, 2 patients achieved PR, 1 SD, 2 PD. There was no significant difference in the shortterm therapeutic effect among 3 molecular subtypes (χ2=4.429, P=0.106). As a result, the progressionfree survival (PFS) of the 104 patients was 1.5121.0 months, and the median PFS was 10.0 months. The median PFS was 11.0 months in Luminal subtype, 4.0 months in TNBC subtype and 10.3 months in HER2 over expression subtype, with a significant difference (χ2=7.510, P=0.006). The most common adverse events were handfoot syndrome (HFS), nausea or vomiting, neutropenia, anaemia, diarrhea and so on. The incidence of grade 2/3 HFS was 44.2% (46/104), and the grade 3/4 neutropenia was 39.4% (41/104). ConclusionThe firstline treatment of MBC using docetaxel plus capecitabine is effective, and the toxicities can be tolerable, especially in the Luminal subtype.

Key words: Breast neoplasms, Neoplasm metastasis, Drug therapy, Molecular classification

欧开萍,马飞,张育荣,刘维丽,吕剑虹,周华. 多西他赛联合卡培他滨一线治疗转移性乳腺癌的临床疗效和不良反应[J]. 国际肿瘤学杂志, 2017, 44(6): 423-.

Ou Kaiping, Ma Fei, Zhang Yurong, Liu Weili, Lyu Jianhong, Zhou Hua. Clinical value and toxicities of docetaxel plus capecitabine in the first line treatment of metastatic breast cancer[J]. Journal of International Oncology, 2017, 44(6): 423-.

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