吉西他滨联合顺铂治疗耐药三阴性晚期乳腺癌的临床观察

Gemcitabine and cisplatin combination chemotherapy for triple-negative meatastatic breast cancer patients with anthracycine resistance

目的 观察吉西他滨联合顺铂方案治疗ER、PR、HER-2均阴性对蒽环类耐药的晚期转移性乳腺癌的疗效和安全性.方法 34例对蒽环或紫杉类耐药晚期转移性乳腺癌患者,经免疫组化证实ER、PR、HER-2均阴性,给予吉西他滨联合顺铂方案治疗,具体用药为：吉西他滨1000mg/m2静脉滴注,第1,8天;顺铂25mg/m2静脉滴注,第1～3天.21天为1周期,至少2个周期,2周期后评价疗效和毒副反应.结果 34例患者均可评价疗效,获完全缓解（CR）2例（5.9%）,部分缓解（PR）12例（35.3%）,稳定（SD）14例（41.2%）,进展（PD）6例（17.6%）,总有效率（CR＋PR）为41.2%;中位疾病进展时间为5.2个月.主要不良反应包括骨髓抑制和胃肠道反应,无化疗相关死亡.结论 吉西他滨联合顺铂方案对蒽环类或紫杉类耐药的转移性三阴性乳腺癌有较好的近期疗效,不良反应可耐受,是有效的解救方案之一.

Objective To evaluate the efficacy and safety of combination chemotherapy of gemcitabine and eisplatin for an- thracyeine-resistant triple-negative metastatic breast cancer patients. Methods Thirty-four patients with immunohistochemical proved triple-negative metastatic breast cancer were given gemcitabine 1000mg/m2 , d1 , d8 and DDP 25 mg/m2 , d1-d3, Treatments were repeated every 21 days and all patients received at ]east two cycles. Results Two eases （5. 9% ） had complete response （CR）, 12 cases （35.3%） had partial response（PR） ,while 14 cases（41.2% ） had stable disease（SD） and 6 cases（20. 6% ） got progressive disease （PD） ;the overall response rate was 41.2%. The median time to progression（TrP） was 5.2 months, no patients died in correlated with lhe gemcitabine combined with cisplatin regimen. Myelosuppression and gastrointestinal tract reaction were the most common toxieities. Conclusion Gemcitabine combined with cisplatin regimen is well effective for patients with anthracycline-resistant triple-negative metastatic breast cancer. Drug-related toxicities are tolerable. This regimen can be considered as a salvage regimen for those patients.