顺铂为主的联合化疗方案治疗复发转移性乳腺癌

The chemotherapy regimen based on cisplatin in the treatment of metastatic breast cancer

目的:观察比较以顺铂为主的GP方案和NP方案治疗复发转移性乳腺癌的疗效和不良反应。方法:94例经病理确诊复发转移性乳腺癌患者随机分为GP(顺铂+吉西他滨)和NP(顺铂+长春瑞滨)两组方案治疗,2周期后评判疗效。结果:GP组有效率(RR)为45.3%,疾病控制率(DCR)为71.7%;中位疾病进展时间(mTTP)为6个月,中位生存期(MST)为14个月;NP组RR为43.9%,DCR为70.7%;mTTP为5个月,MST为11个月,两组差异无显著性(P>0.05)。不良反应主要为骨髓抑制和消化道反应,GP组Ⅲ～Ⅳ度白细胞下降发生率为15.1%、Ⅲ～Ⅳ度血小板下降发生率为24.5%,Ⅲ～Ⅳ度恶心呕吐发生率为17.0%;NP组Ⅲ～Ⅳ度白细胞下降发生率为26.8%、Ⅲ～Ⅳ度血小板下降发生率为7.3%,Ⅲ～Ⅳ度恶心呕吐发生率为14.6%,两组除血小板下降有显著性差异(P<0.05)外,其余均无统计学意义(P>0.05);未见Ⅲ～Ⅳ度肾脏及肝脏损害。结论:GP和NP两组方案治疗复发转移性乳腺癌疗效较好,两组疗效相似,不良反应轻。两组方案均可作为治疗复发转移性乳腺癌的解救方案。

Objective：To compare the efficacy and side effects between GP regimen and NP regimen in the treatment of metastasis breast cancer, nethods：Ninty-four patients were randomly pathologically diagnosed metastasis breast cancer. They were divided into GP group and NP group. Results：The RR of GP group was 45.3% ,DCR was 71.7% ,mTTP was 6 months,MST was 14 months. In the NP group,RR was 43. 9% ,DCR was 70. 7% , mTTP was 5 months,MST was 11 months. There were no statistical difference between the two groups（ P 〉 0. 05 ）. The major side effects were hematological side effects and gastrointestinal effects. In the GP group, grade 3 to grade 4 white blood cell count decreased in 15.1% patients, grade 3 to grade 4 platelet count decreased in 24. 5% patients, grade 3 to grade 4 gastrointestinal side effects was17. 0%. In the NP group, grade 3 to grade 4 white blood cell count decreased in 26. 8% patients,grade 3 to grade 4 platelet count decreased in none,grade 3 to grade 4 gastrointestinal side effects was 14. 6%. Except the plate let,there were no statistical difference between the two groups about the side effects. Renal or liver side effects were not observed. Conclusions：GP and NP regimens were efficacious in the treatment of metastasis breast cancer,the survival was long, the side effects were endured,there were no statistical difference about effects between the two groups. They both can be choosed in the treatment of metastasis breast cancer.