吉西他滨联合顺铂治疗蒽环类和(或)紫杉类耐药晚期乳腺癌的近期疗效观察

Effect of gemcitabine plus cisplatin in advanced breast cancer with anthracycines and /or taxanes resistance

背景与目的:蒽环类和(或)紫杉类药物在新辅助和(或)辅助治疗中的广泛应用增加了乳腺癌复发转移后选择解救治疗药物的难度,有研究证明吉西他滨(gemcitabine,GEM)、顺铂(cisplatin,DDP)对乳腺癌明确有效。据此,本文旨在评估GEM联合DDP治疗蒽环类和(或)紫杉类耐药晚期乳腺癌的近期疗效。方法:收集2005年5月8日—2007年1月31日,采用GEM1000mg/m2(d1,d8)及DDP30mg/m2(d1～d3)3周方案治疗蒽环类和(或)紫杉类耐药的晚期乳腺癌患者34例。中位化疗5个周期(2～6个周期),所有患者随访超过6个月。结果:完全缓解(CR)3例(8.8%),部分缓解(PR)13例(38.2%),稳定(SD)12例(35.3%),进展(PD)6例(17.7%);总有效率(CR+PR)47.0%,中位疾病进展时间(TTP)6.5个月。不良反应Ⅲ/Ⅳ血小板减少或腹泻常见。结论:GEM联合DDP方案可用于蒽环类和(或)紫杉类耐药晚期乳腺癌的解救治疗。

Background and purpose：Ever since the use of anthracycine and /or taxanes-based regimen for the adjuvant and/or neoadjuvnat chemotherapy of breast cancer,there have few sensitive agents for advanced breast cancer（ABC）when it occurs drug resistance to anthracycine and /or taxanes.The aim of this study is to evaluate the effect of gemcitabine plus cicplatin in advanced breast cancer after the failure of treatment with anthracycines and /or taxanes.Methods：From May,2005 to Jan 2007,34 ABC cases with anthracycine and/or taxanes resistance were treated with GEM（1000 mg/m2.day1,day8）and DDP（30 mg/m2,day 1 to day 3）every 3 weeks.A median of 5 cycles（2-6 cycles）of the treatment was delivered.All cases were followed up more than 6 months.Results：3 cases（8.8%）had complete response（CR）,13 cases（38.2%）had partial response（PR）,while 12 cases（35.3%）had stable disease（SD）and progressive disease（PD）was 6 cases（17.7%）;the overall response rate was 47.0%.The median time to progression（TTP）was 6.5 months,grade 3/4 diarrhoea and thrombocytopenia were main side effects.Conclusions：GEM plus DDP are effective in the treatment of advanced breast cancer with anthracycine and/or taxanes resistance.