转移性乳腺癌单药多烯紫杉醇每周方案与每3周方案疗效与毒性的临床研究

Efficacy and toxicity of docetaxel as a single agent in treating metastatic breast cancer with weekly and 3 weekly scheme

目的 研究单药多烯紫杉醇每周方案及每3周方案治疗转移性乳腺癌的疗效与毒性。方法 32例转移性乳腺癌患者，接受不同方案单药多烯紫杉醇的治疗，每周方案每次剂量范围为40～60mg，相当于20．4～28．7mg／m^2，中位剂量为25mg／m^2；3周方案剂量范围为每3周120～160mg，相当于70.9～86.1mg／m^2，中位剂量为75mg／m^2。评估多烯紫杉醇不同用药方案疗效与毒性的关系。结果 单药多烯紫杉醇有效率为25．0％，对软组织疗效为60.0％，肝转移疗效为27．8％。分每周及每3周方案讨论。每周方案中，KPS评分≤70的患者多，曾用辅助治疗的较多，但疗效与3周方案相似，均为25．0％。每3周方案的Ⅲ～Ⅳ度白细胞毒性大，而每周方案白细胞毒性轻，耐受性良好。结论 单药多烯紫杉醇治疗转移性乳腺癌疗效肯定。每周方案，对老年、一般状态差、部分难治性乳腺癌仍有疗效，且与每3周方案疗效相似。

Objective To compare the efficacy and toxicity of docetaxel as a single agent for treating metastatic breast cancer with weekly and 3 weekly scheme. Methods Thirty - two patients with metastatic breast cancer received docetaxel as a single agent with different scheme. One with the dose ranging 40 ～ 60mg was given every week （20.4～28.7mg/m^2, median delivered dose intensity 25mg/m^2）. The other group with the dose ranging 120 ～ 160mg given every three weeks（70.9 ～ 86. 1mg/m^2, median delivered dose intensity 75rag/m^2）. Efficacy and toxicity was evaluated. Results The response rate（RR） of docetaxel as a single agent was 25%, the RR of this drug in lung - metastatic and liver - metastatic patients were 60. 0% and 27.8%, respectively. This drug was administered as either one - week or 3 - week protocol. Although the efficacy was similar in these two protocol. The Ⅲ～Ⅳ grade of hematological toxicity was relatively high in later protocol. Toxicity was lower and tolerable in the one -week protocol. Conclusion metastatic breast cancer, when used as one- week protocol, it has certain those who are refractory or whose performance status are poor, as does the three- week protocol.