卡培他滨联合多西紫杉醇治疗蒽环类耐药的转移性乳腺癌31例

Analysis of thirty-one patients with metastatic breast cancer resistant to anthracyclins treated with docetaxel plus capecitabine

为了探讨卡培他滨联合多西紫杉醇（DTX）治疗蒽环类耐药的转移性乳腺癌的疗效及不良反应，将61例确诊蒽环类耐药的转移性乳腺癌分为两组，联合组31例卡培他滨1650mg／（m^2·d），口服，d1～d14，DTX75mg／（m^2·d），静脉滴入，d1。时照组30例DTX 100mg／（m^2·d），静脉滴入，d1。两组每3周为1个周期，连用4个周期，治疗结束2周后评价疗效。61例均可评价疗效，联合组有效率（CR＋PR）为45．2％（14／31），中位生存时间为14．3个月。Ⅱ～Ⅲ度反应占67．7％（21／31），Ⅳ度反应占29．0％（9／31），主要为手足综合征、骨谴抑制、脱发和消化道毒性。时照组有效率（CR＋PR）为30．0％（9／30），中位生存时间为10．9个月。Ⅱ～Ⅲ度反应占50．0％（15／30）。Ⅳ度反应占33．3％（10／30），主要为发热、肌痛、关节痛、嗜中性粒细胞减少症。初步研究结果提示，卡培他滨联合DTX时经吡柔比星治疗失败的乳腺癌较DTX’单药有优势，且不良反应可以耐受。

The objective of this study was to investigate the efficacy and adverse effect on patients with metastatic breast cancer resistant to anthracyclins treated with docetaxel （DTX） plus capecitabine. Sixty-one patients metastatic breast cancer resistant to anthracyclins were randomized into two groups , 31 cases in the experimental group and 30 cases in the control group. The experimental group： Capecitabine 1 650 mg/（m^2 · d）, d1 --d14, DTX 75 mg/（m^2 · d）, intravenous infusion, d1. The control group： DTX 100 mg/（m^2 · d） ,intravenous infusion, d1. The 2 regimens were repeated every 3 weeks and totally 4 cycles. The evaluation was performed at 2 weeks after the completion of chemotherapy. Sixty-one patients all had evaluable lesions. For the experimental group： RR rate was 45.2% （14/31） and MST 14. 3 months. Grade Ⅱ- Ⅲ toxicity （67. 7% ,21/31） and Grade Ⅳ （29 %） were mainly hand-foot syndrome, myelosuppression, alopecia and GI discomfort. For the control group： the RR rate was 30. 0% （9/30） and MST 10. 9 months. Grade Ⅱ- Ⅲ toxicity （50. 0% ,15/30） and Grade Ⅳ （33.3% ,10/30）, were mainly fever,myalgia, anthralgia and neutropenia. Our results show that DTX plus capecitabineis is effective to patients with metastatic breast cancer resistant to anthracyclins and the toxicity is acceptable.