来曲唑与TP-来曲唑序贯方案治疗绝经后晚期乳腺癌

Letrozole Versus TP-Letrozole Regimen in the Treatment for Postmenopausal Women with Advanced Breast Cancer

[目的]比较来曲唑与TP-来曲唑序贯联用两种方案治疗绝经后晚期乳腺癌的疗效和不良反应。[方法]47例晚期绝经后乳腺癌随机分为两组,A组23例接受来曲唑2.5mg,口服,每天1次,30天为1个周期;B组24例先接受TP方案(多西紫杉醇、顺铂)化疗2个疗程,继服来曲唑,方法同A组。[结果]两组有效率分别为39.1%和41.7%,临床获益率分别为69.6%和70.8%(P>0.05),在不同的受体状态、绝经情况、治疗阶段,两组疗效无差异(P>0.05),B组对内脏转移疗效高于A组(P<0.01);两组中位疾病进展时间(TTP)及中位缓解期分别为6.5个月vs.7.5个月和9.6个月vs.11.6个月(P>0.05)。两组主要不良反应为Ⅰ～Ⅱ级的消化道反应、骨髓抑制和乏力。[结论]单服来曲唑和TP-来曲唑序贯方案治疗绝经后晚期乳腺癌安全、疗效肯定,可作为一线方案。对伴内脏转移患者,首选TP-来曲唑序贯方案。

[Purpose]To compare the efficacy and safety of letrozole and TP-letrozole regimen in the treatment for postmenopausal advanced breast cancer. [Methods]Forty-seven cases with postmenopausal women with advanced breat cancer were randomized divided into two groups：23 patients with letrozole 2.5mg once daily, for 30 days as one cycle （group A）, 24 with two cycles of TP（docetaxel plus cisplatin） combination chemotherapy followed by letrozole same as group A （group B）. [Results]The response rate was 39,1% in group A and 41.7% in group B（P〉0.05）, and the clinical beneficial rates was 69.6% and 70.8% respectively （P〉0.05）.There were no significant difference in efficacy between two groups with different receptor status, and menopausal status （P〉0.05）. Group B is superior to group A in efficacy for visceral metastasis（P〈0.01 ）.Median time to progression（mTTP） and duration of response in group A and B were 6.5 months vs. 7.5 months and 9.6 months vs. 11.6 months respectively （P〉0.05）.The main side effects in two groups were Ⅰ - Ⅱ degree digestive tract toxicity, myclosuppression and hypodynamia. [Conclusions]Letrzole and TP-letrozole regimens are safe and effective and could be considered as a first line treatment for postmenopausal advanced breast cancer.TP-letrozole regimen maybe the first choice for visceral metastasis patient.