初治“三阴”性复发转移性乳腺癌化疗疗效回顾性分析

The retrospective analysis of the chemotherapy outcomes in 311 triple-negative recurrent or metastatic breast cancer patients

目的回顾性分析初治的雌孕激素受体(ER/PR)及HER_2均阴性(简称"三阴")的复发转移性乳腺癌的化疗疗效,寻求最佳一线化疗方案。方法311例初治的"三阴"性复发转移性乳腺癌患者采用一线化疗,96例患者采用AC(吡柔比星+环磷酰胺)方案,84例患者采用AT(吡柔比星+紫杉醇)方案,65例患者采用TC(紫杉醇+卡铂)方案,66例患者采用GT(吉西它滨+紫杉醇)方案,直至肿瘤进展。结果AC方案组总反应率(ORR)、中位疾病进展时间(mTTP)、中位总生存(mOS)均明显优于其他组,差异均有显著性(P<0.05),而AT组、TC组、GT组在ORR、mTTP、mOS方面均相似,差异均无显著性(P>0.05)。结论在初治的"三阴"性复发转移性乳腺癌患者中,AC方案是目前最有效的联合方案之一,一线治疗有效率高达87.5%,值得推荐。

Objective To retrospectively analysize the chemotherapy outcome of recurrent or metastatic breast cancer with negative ER, PR and HER2 （triple-negative）and to look for the optimal first-line chemotherapy regimens. Methods A total of 311 recurrent or metastatic breast cancer patients were randomized to treatment with A （ pirarubicin ） plus C （ cyclophosphamide, 96 ）, A plus T （ taxol, 84 ）, T plus C （ carboplatin ,65 ）, or G（ gemcitabine ） plus T （ 66 ）. Responders （ complete or partial） or those with stable disease were treated until progression of disease. Results The overall response rate in the AC group was higher than those in other groups, significantly different from the other groups. The median time to progression and overall survival were significantly prolonged in the AC group as compared with the other groups. Conclusions The AC regimen is one of the most effective regimens ,with the response rate of 87.5% , and it is deserved to be recommended.