紫杉醇联合顺铂治疗30例蒽环类耐药性晚期乳腺癌的疗效分析

Paclitaxel and cisplatin in treatment of anthracycline-resistant advanced breast carcinoma

目的观察紫杉醇联合顺铂方案治疗蒽环耐药性晚期乳腺癌的疗效与安全性。方法我院2000年6月至2004年10月,采用紫杉醇联合顺铂方案治疗蒽环类耐药性晚期乳腺癌30例。紫杉醇175mg/m2d1,静脉点滴;顺铂75mg/m2d1,静滴,(或分2～3天给药),加水化、利尿、止吐治疗,21天为1周期。本组中位化疗周期数为3个。结果全组完全缓解(CR)5例(16.7%),部分缓解(PR)9例(30.0%),稳定(SD)8例(26.7%),疾病进展(PD)8例(26.7%),总有效率(RR=CR+PR)为46.7%。中位肿瘤进展时间(TTP)8个月,1年生存率为56.7%,中位生存期为15个月。一般情况较好者(KPS90～100分)疗效好于一般情况较差者(KPS70～80分),RR分别为66.7%和26.7%(P=0.033),单发转移瘤患者疗效较多发转移瘤者高(RR分别为72.7%和31.6%,P=0.035)。主要毒性反应为骨髓抑制及胃肠道反应。结论紫杉醇和顺铂联合方案治疗蒽环类耐药性乳腺癌疗效较好,使用方便,毒性反应较轻,是蒽环类耐药的晚期乳腺癌的有效解救治疗方案。

Objective To evaluate the efficacy and safety of chemotherapy of paclitaxel （FFX） combined with cisplatin （DDP） for anthracycline -resistant advanced breast cancer （ABC）. Methods From June 2000 to October 2004, 30 patients with anthracycline - resistant ABC were treated with combination chemotherapy of PTX and DDP. PTX 175mg/m^2, DDP 70mg/m^2 were used on day 1 every three weeks. The median number of cycles was 3 （range： 2 - 6 ）. Results The overall response rate was 46. 7% with a median time to progression of 8 months. One - year survival rate was 56. 7%. The patients with good performance statue have higher response rate than bad performance statue （RR： 66. 7% vs 26. 7%, P = 0. 033 ）. The patients with one metastastic tumor have higher response rate than more metastastic tumor （RR： 72. 7% vs 31.6%, P =0. 035）. The main side effects were gastrointestinal and hematologic toxicities. Conclusion Paclitaxel and cisplantin combination is active in the treatment for anthracycline- resistant ABC patients with acceptable toxicity, and may be a therapeutic alternative for patients with good performance statue or one metastastic tumor.