多西他赛为主的联合方案一线治疗晚期乳腺癌的临床观察

Clinical Observation of Combination Chemotherapy Based on Docetaxel as First-line in the Treatment of Advanced Breast Cancer

目的:观察多西他赛联合表阿霉素或顺铂一线治疗晚期乳腺癌的疗效和安全性。方法:62例晚期乳腺癌患者,将既往用蒽环类药物辅助化疗后转移的29例患者及3例不宜用蒽环类药物且未接受过辅助化疗的患者,予多西他赛联合顺铂(TP方案)化疗;将既往用CMF方案辅助化疗后转移的17例患者及13例既往未接受过辅助化疗的患者,予多西他赛联合表阿霉素(TE方案)化疗。TE组药物剂量多西他赛75mg.(m2)-1,表阿霉素60mg·(m2)-1,d1;TP组药物剂量为多西他赛75mg·(m2)-1,d1,顺铂25mg·(m2)-1,d1～3,21天为1周期,2个周期末评价近期疗效及安全性。结果:62例患者均可评价疗效,其中CR7例,PR29例,SD17例,PD9例,总有效率为58.1%,TE组和TP组有效率分别为60.0%和56.3%(P=0.963),临床受益率分别为86.7%和84.4%(P=0.897),TTP分别为10.2个月和9.0个月(P=0.713)。不良反应主要是骨髓抑制、脱发、消化道反应,但均可耐受,无化疗相关死亡。结论:多西他赛联合表阿霉素或顺铂方案一线治疗晚期乳腺癌有较好的疗效,不良反应可以耐受,且TE和TP方案的疗效及安全性相当。

OBJECTIVE：To evaluate the efficacy and safety of docetaxel combined with cisplatin or epirubicin in the treatment of patients with advanced breast cancer. METHODS： The sixty - two patients with advanced breast cancer, twenty-nine patients previously failured to adriamycin-based chemotherapy and three patients unsuitable using adriamycin - based chemotherapy and don＇ t received adjuvant chemotherapy, received the regimen of docetaxel plus cisplatin （TP regimen）, that the another 17 patients received CMF regimen but metastatic after chemotherapy and 13 patients don＇t received any adjuvant chemotherapy before, received doeetaxel plus epirubicin （TE regimen）. The patients received doeetaxel 75 mg.（ m^2 ）^-1 , d1 plus epirubicin 60mg.（ m^2 ）^-1 , d1 （TE group） or docetaxel 75 mg.（ m^2 ）^-1 , d1 plus eisplatin 25 mg.（ m^2 ）^-1 , d1-3 （TP group） administrated intravenously, the regimen was repeated every 21 days and the clinical response was assessed after two cycles. RESULTS ： CR 7 cases, PR 29 eases, SD 17 cases, PD 9 cases, the overall response rate was 58.1% , in TE and TP groups were 60.0% and 56.3% , respectively （ P = 0.963）, Disease control rates for TE and TP groups were 86.7% and 84.4%, respectively （ P = 0.897）. The median time to progression was 10.2 months for TE versus 9.0 months for TP groups （ P = 0.713）. The main toxicities included myelosuppression, nausea, vomiting and alopecia, but they were tolerable. There were no any deaths during treatment. CONCLUSION： Both TE and TP regimens as first - line chemotherapy were similarly better effective, safe and tolerable in the treatment for advanced breast cancer.