GP与NP方案治疗耐药晚期乳腺癌的临床观察

Clinical observation of GP and NP regimen in patients with advanced breast cancer

目的比较古西他滨联合顺铂（GP方案）和长春瑞滨联合顺铂（NP方案）治疗蒽环和（或）紫杉类耐药转移性乳腺癌的近期疗效和安全性。方法采用GP方案（吉西他滨＋顺铂）36例，吉西他滨1000mg／m^2静脉滴注，第1，8天给药；顺铂75mg／m^2分3次静脉滴注，第1—3天给予。采用NP方案（长春瑞滨＋顺铂）32例，长春瑞滨25mg/m^2，第1，8天给予；顺铂用法同A组。两方案均每3周重复，2个周期以上评价疗效。结果两组有效率分别为55．6％（20／36）和53．1％（17／32），无统计学意义（χ^2=0．0403，P=0．84）。GP组Ⅲ—Ⅳ度血小板减少高于NP组，但NP组静脉炎相对较明显。结论GP与NP方案治疗蒽环类和（或）紫杉类耐药的晚期乳腺癌有较高的有效率，可指导临床，且不良反应均可以耐受。

Objective To evaluate the efficacy and safety of gemcitabine and cisplatin versus navelbine and cisplatin in anthracycline- and（or） taxane -resistant metastatie breast cancer（MBC）. Method A total of 68 patients with metastatic breast cancer were randomly assigned to receive the regimen of GP（ n = 36） or Np（ n = 32）. Group GP：Gemcitabine 1 000 mg/m^2,d1 .d8; DDP 25 mg/m^2, d1 - 3. Group NP： Navelbine 25mg/m^2 ,d1, d8 ; DDP25 mg/m^2, d1 -3. Two groups were treated at least 2 courses with 3 weeks interval, efficacy was evaluated after 2 courses of chemotherapy. Results The response rate was 55.6% （20/36）in group GP,and 53.1% （ 17/ 32） in group NP. The degree Ⅲ- Ⅳ thrombocytopenia was more common in group GP than in the group NP,but the degree phlebitis was more serious in group NP. Conclusion NP and GP for treating refractory metastatic breast have a high response rate, there was no significant difference between two groups（ χ^2 = 0.0403 ,P =0.84）. Two groups haw; tolerable side effects.