吉西他滨联合顺铂一线或二线治疗晚期三阴性乳腺癌的临床观察

Gemcitabine plus cisplatin as first-or second-line therapy for metastatic triple negative breast cancer

目的 观察吉西他滨联合顺铂一线或二线方案治疗晚期三阴性乳腺癌的近期疗效和毒副反应.方法 54例晚期三阴性乳腺癌患者接受吉西他滨联合顺铂治疗,其中一线治疗45例,二线9例,具体方案：吉西他滨1000mg/m2 d1、d8,顺铂25mg/m2 d1～d3,21天为1周期.每2周期评价疗效,每周期进行安全性评估.结果 54例患者中位治疗周期数为6周期（2～8周期）,获CR 8例（14.8%）,PR 24例（44.4%）,SD 18例（33.3%）,PD 4例（7.4%）,总有效率（CR＋PR）为59.2%.主要毒副反应为骨髓毒性和消化道反应,3～4级毒性分别为中性粒细胞减少40.7%,血小板减少35.2%,乏力18.5%,食欲下降14.8%,贫血11.1%,恶心呕吐9.2%,外周神经毒性1.9%.结论 吉西他滨联合顺铂治疗晚期三阴性乳腺癌近期疗效好,毒副反应可以耐受,可推荐作为晚期三阴性乳腺癌的治疗选择.

Objective To evaluate the efficacy and safety of combination chemotherapy of gemcitabine and cisplatin（DDP） as first-or second-line therapy for metastatic triple negative breast cancer（TNBC）. Methods Fifty-four metastatic TNBC patients received 21-day cycles of gemcitabine 1000mg/m^2 on day 1 and day 8, and DDP 25 mg/m^2 on day 1 and day 3. Forty-five patients received GP regimen as first-line and 9 as second-line treatment. Response rate was evaluated every two cycles and toxicity was evaluated every cycle. Results The median number of treatment was 6 cycles（2-8 cycles）. The overall response rate was 59.2% , CR 14. 8% , PR 44.4%, SD 33.3% and PD 7.4%. The main treatment-related toxieities were hematologic toxicity and gastrointestinal reaction. Grade 3/4 toxicity included neutropenia 40. 7% , thrombocytopenia 35. 2% , fatigue 18.5% , anorexia 14. 8%, anemia 11. 1% , nausea/vomiting 9. 2% , neuropathy 1.9%. Conclusion Combination therapy of gemcitabine and cisplatin is an effective and well tolerated regimen in metastatic TNBC patients.