多西紫杉醇联合卡培他滨治疗晚期乳腺癌的临床观察

Clinical observation on treatment of advanced treast cancer with docetaxel combined with capecitabine

目的 观察多西紫杉醇联合卡培他滨治疗蒽环类药物治疗失败复发转移性乳腺癌的近期疗效和不良反应,并与长春瑞滨（NVB）和顺铂（DDP）组成的NP方案进行比较.方法 蒽环类药治疗失败的复发转移性乳腺癌患者,选择匹配68例,分为A（治疗组）和B（对照组）两组. A组32例接受多西紫杉醇联合卡培他滨方案,多西紫杉醇75 mg/m2,静滴,第1天;卡培他滨950 mg/mv2,每日2次口服,第1～14天.B组36例采用NP方案,NVB 25 mg/m^2,第1、8天,静滴;DDP 80 mg/m^2,分3 d（d1～3）静滴,每3周重复一次.治疗2个周期以上评价疗效.结果 68例患者均可行疗效和不良反应评价,A组和B组有效率分别为71.9%（23/32）和44.4%（16/36）,两组差异有显著性（P＜0.05）;中位肿瘤进展时间（TTP）A组和B组分别为5.7个月和3.8个月,差异有显著性（P＜0.01）.两组主要不良反应均为中性粒细胞减少,A组和B组Ⅲ、Ⅳ度中性粒细胞减少发生率分别为53.1%和44.4%,差异无显著性（P＞0.05）.A组主要不良反应还有手足综合征,多为Ⅰ～Ⅱ度.结论 多西紫杉醇联合卡培他滨是治疗蒽环类治疗失败复发转移性乳腺癌的有效方案,其有效率优于NP方案,不良反应可以耐受.

Objective To evaluate the efficacy and toxicity of doeetaxel-eapeeitabine combination and compare with vinorelbine-eisplatine（NVB-DDP） combination in treatment of patients with metastatic breast cancer who failed in prior treatment with anthraeyeline. Methods Patients were divided into two groups ,A and B . In group A, 32 patients received doeetaxe175 mg/m^2 iv gtt,dl, eapeeitabine 950 mg/m^2 po bid,d1-14,the cycle was repeated every 3 weeks. In group B, 36 patients received NVB 25 mg/ m^2,iv gtt,d1 and dS,DDP 80 mg/m^2 iv gtt in 3 days（d1-3）,the cycle was repeated every 21 days. The patients were evaluated for the response after two cycles. Results Sixty-eight patients were evaluated for response and toxicity. The response rate of group A and group B was 71.9% （23/32） and 44.4% （ 16/36 ） respective- ly. The difference between the two groups was significant （ P 〈 0.05 ） . In group A and group B, the median time to disease progression（TIP） was 5.7 months and 3.8 months respectively. The difference between the two groups was significant （P 〈0.01 ） . The incidence of grade Ⅲ-Ⅳ neutropenia in group A and group B was 53.1% and 44.4% respectively. The difference between the two groups was not significant （ P 〉 0.05 ）. The incidence of hand-foot syndrome（HFS） was 43.7% in group A. Conclusions The combination of doeetaxel and eapeeitabine is an effective regimen for the patients who failed in prior treament with anthraeyelin. The overall toxicity was acceptable. Doeetaxel and eapeeitabine combination regimen had higher response rate than NVB and DDP combination regimen.