健择联合卡培他滨治疗晚期乳腺癌55例临床观察

Clinical observation on gemzar combined with capecitabine in the treatment of patients with metastatic breast cancer:a report of 55 cases

为观察及评价盐酸吉西他滨(健择)联合卡培他滨(希罗达)治疗复发转移性乳腺癌的疗效和不良反应,武汉钢铁集团公司第二职工医院肿瘤中心对55例晚期乳腺癌患者均给予健择1000mg/m2,静脉滴入,d1、d8;希罗达口服,2次/d,餐后服用,每次1000mg/m2,连续服用14d;治疗周期为21d,至少治疗2个周期。结果完全缓解(CR)7例,部分缓解(PR)30例,稳定(SD)15例,疾病进展(PD)3例,总有效率67.3%,中位TTP6.5个月。不同转移部位或器官的有效率分别为:胸壁83.3%(15/18),淋巴结80.0%(20/25),肺脏75.0%(15/20),骨骼41.7%(5/12),肝脏28.0%(7/25)。Ⅰ、Ⅱ级不良反应为皮肤色素沉着40例,手足综合征35例,恶心呕吐30例,腹泻25例,白细胞下降40例,Ⅲ、Ⅳ级不良反应为白细胞下降7例,恶心呕吐3例,贫血3例。初步观察结果提示,健择联合希罗达治疗晚期乳腺癌疗效肯定,患者耐受性良好。

The objective of this study was to observe and evaluate the therapeutic effect and adverse reaction of gemcitabine hydrochloride combined with capecitabine in the treatment of metastatic breast cancer. Fifty-five patients diagnosed as metastatic breast cancer received at least 2 cycles of the chemotherapy, which consisted of gemcitabine hydrochloride 1 000 mg/m^2 , d1 , d8, iv drip and capecitabine 1 000 mg/m^2 d1- d14 po. bid. The chemotherapy was given every 21 days. There were 7 complete remissions （CR）, 30 partial remissions （PR）, 15 stable diseases （SD） and 3 progressive disease （PD）. The total effective rate was 67.3%, and the median TTP was 6.5 months. The effective rates of different metastatic sites or organs were： the chest wall 83.3% （ 15/18）, lymph nodes 80.0% （20/25）, lung 75.0% （15/20）, bone 41.7% （5/12） and liver 28. 0% （7/25）. The adverse effects classified as Ⅰ/Ⅱ grade were listed as below： 40 cases of skin hyperpigmentation, 35 cases of hand-foot syndrome, 30 cases of nausea and vomiting, 25 eases of diarrhea and 40 eases of leukocyte decrease. The adverse effects classified as Ⅲ/Ⅳ grade were： 7 cases of leukocyte decrease, 3 case of nausea and vomiting, 3 case of anaemia. In conclusion, the regimen combining gemcitabine hydrochloride with capecitabine has a positive curative effect on metastatic breast cancer and very good tolerance.