GP与NP方案治疗对蒽环类及紫杉类均耐药的转移性乳腺癌的疗效观察

Clinical Comparison of Gemcitabine Combined Cisplatin Regimen Versus Vinorelbine Combined Cisplatin Regimen as Chemotherapy for Anthracycline-and Taxane-resistant Metastatic Breast Cancer

目的比较GP(吉西他滨/顺铂)和NP(长春瑞滨/顺铂)方案治疗对蒽环类及紫杉类均耐药转移性乳腺癌(MBC)的疗效及不良反应。方法采用GP和NP方案治疗对蒽环类及紫杉类均耐药MBC58例,比较患者的总有效率(ORR)、总生存时间(OS)、肿瘤进展时间(TTP)及1年生存率。结果GP组ORR为33.3%(10/30),CR6.7%(2/30),PR26.7%(8/30);NP组ORR为32.1%(9/28),CR7.1%(2/28),PR25.0%(7/28)。两组ORR差异无统计学意义(P=0.923)。GP组中位OS为19.9(95%CI11.8～28.0)个月,中位TTP为9.2(95%CI7.0～11.4)个月,1年生存率为69.0%;NP组中位OS为19.1(95%CI14.4～23.8)个月,中位TTP为(95%CI2.5～6.7)4.6个月,1年生存率为67.9%,两组中位OS(P=0.888)和1年生存率(P=0.924)差异无统计学意义,GP方案中位TTP优于NP方案(P=0.024)。两组均无化疗相关死亡病例,主要不良反应为骨髓抑制及胃肠道反应。结论NP与GP方案对蒽环类及紫杉类均耐药MBC均有较好的近期疗效,不良反应均可耐受,同为有效解救方案。

Objective To compare the efficacy and toxicities of gemcitabine combined cisplatin （GP） regimen and vinorelbine combined cisplatin（NP） regimen as chemotherapy for anthracycline - and taxane -resistant metastatic breast cancer （MBC）. Methods 58 patients were treated by GP or NP regimen. Overall response rate （ORR） , overall survival （OS） , time to progression（TTP） and 1 -year survival of two groups were assessed after treatment. Results CR was 6.7% （2/30） and PR was 26.7% （8/30） in GP group. 2 patients （7.1% ） had a complete response（CR） and 7 pattens （25.0%） had a partial response （PR） in NP group. No statistically significant difference was observed in terms of ORR（33.3% vs. 32.1%. ,P = 0.923 ）, median OS （ 19.9 vs. 19.1 months, P = 0.888 ） or 1 - year survival rate （ 69.0% vs. 67.9 % , P = 0. 924 ） of the two groups. GP group appeared to be more favorable in median TFP than NP group （ 9.2 vs. 4.6 months, P = 0. 024 ）. No patients died in correlated with the two regimens. Myelosuppression and gastrointestinal tract reaction were the most common toxicities. Conclusion GP and NP regimens are both well effective for patients with anthracycline - and taxane - resistant MBC. Drug - related toxicities are tolerable. Two regimens can be considered as salvage regimens for those patients.