紫杉醇联合顺铂治疗57例晚期乳腺癌的临床疗效分析

Paclitaxel and cisplantin in the second-line treatment of advanced breast carcinoma

目的:观察紫杉醇联合顺铂(DDP)方案治疗晚期乳腺癌(ABC)及蒽环类耐药性乳腺癌的疗效与安全性。方法:采用紫杉醇联合DDP方案治疗ABC57例(其中含蒽环类耐药性乳腺癌26例)。紫杉醇175mg/m2,静脉滴入,d1(或分为d1、d8);DDP70mg/m2,静脉滴入,d1(或分为d1～d3),加水化、利尿和止吐治疗,21d为1个周期。本组中位化疗周期数为3个。结果:完全缓解6例,部分缓解24例,稳定16例,疾病进展11例,总的有效率52.6%(30/57),26例蒽环类耐药性乳腺癌患者的有效率为61.5%(16/26)。治疗时一般情况较好者疗效(53.5%)好于一般情况差者(23.3%),P=0.045。中位肿瘤进展时间7个月,1年生存率为61.4%,中位生存期为19个月。主要毒性反应为骨髓抑制及胃肠道反应。结论:紫杉醇和DDP联合方案治疗ABC,特别是蒽环类耐药性乳腺癌疗效较好,使用方便,毒性反应较轻。该方案是包括蒽环类耐药性ABC的有效解救治疗方案。

OBJECTIVE： To evaluate the efficacy and safety of chemotherapy of paclitaxel（PTX） combined with cisplantin （DDP） for advanced breast cancer, including anthracycline-resistant advanced breast cancer （ABC）. METHODS： 57 patients with ABC（including 26 patients with anthracycline resistant ABC） were treated with combination chemotherapy of PTX and DDP. PTX 17,5 mg/m^2 DDP 70 mg/m^2 were used on day 1 every three weeks. The median number of cycles was 3. RESULTS： The overall response rate was 52.6% with a median time to progression of 7 months. One-year survival rate was 61.4% The response rate in 26 patients with anthracycline-resistant ABC was 61.5%. Patients with good performance statue have higher response rate than those with bad performance statue. The main side effects were gastrointestinal and hematologic toxicities. CONCLUSION： Paclitaxel and cisplantin combination is active in the treatment for ABC expecially for anthracycline-resistant ABC patients with acceptabale toxicity, and may he a thera- peutic alterna＂cive after anthraeycline regimen has faild.