吉西他滨联合顺铂二、三线治疗晚期三阴乳腺癌临床观察

Clinical observation of gemcitabine combined with cisplatin as second-or third-line on patients with advanced triple-negative breast cancer

目的观察吉西他滨／顺铂21天方案（GP方案），二、三线治疗转移性三阴乳腺癌（advanced triplenegative breastcancer，ATNBC）患者的疗效和不良反应。方法34例三阴乳腺癌患者，吉西他滨1．0g／In。第1、8天静脉滴注；顺铂25mg／m2。第1—3天静脉滴注，21天为一疗程，直到疾病进展或无法耐受或最多接受6周期化疗。结果34例患者共完成141个周期化疗，中位化疗周期3．5周期。均可评价疗效和不良反应。其中完全缓解0例（0％），部分缓解11例（32．35％），稳定9例（26．44％），进展14例（41．18％）。有效率（CR＋PR）32．4％（95％可信区间24．15％-40．55％），疾病控制率（CR＋PR＋SD）58．8％，中位疾病进展时间（TTP）3．9月，中位生存期（OS）10.0月。治疗后主要不良反应为血液学毒性，血小板减少发生率为61．8％。结论三阴性乳腺癌预后差，GP方案治疗ATNBC患者安全有效，不良反应可以耐受。

Objective To evaluate the clinical efficacy and tolerability of a 3-week regimen of cisplatin（DDP） with gemcitabine （GEM） as second- or third-line for patients with advanced triple-negative breast cancer. Methods Thirty-four patients with advanced triple-negative breast cancer were enrolled in this study. All the patients were given gemicitabine 1.0 g,/m2 on days 1,8 ,combined with cisplatin 25 mg/m2 daily on days 1 -3. The combined chemotherapy was repeated every 21 days as one cycle. The maximum of 6 cycles were given. Results All of the 34 patients completed 141 cycles of chemotherapy with a median number of 3.5 cycles per patient. Toxicity and clinical efficacy were evaluated on all the 34 patients. No patents （0%） achieved a complete response, 1l patients （32.4%） had a partial response, stable disease was documented in 9 patients （26.4%）, while progressive disease occurred in 14 patients （41.2%）. The overall response rate （ CR ＋ PR） was 32.4% （95% CI：24.15% -40.55% ） and disease control rate （ CR ＋ PR＋ SD） was 58.8%. The median time to progress （TI＇P） was 3.9 months,and median overall survival time （OS） was 10.0 months. The major adverse event of drugs was hematologic toxicity, The incidence of I ~ II grade thrombocytopenia was 61.8%. Conclusions Metastatic triple-negative breast cancer contributes to the poor prognosis. Cisplatin combined with gemeitabine is an effective and safe chemotherapeutic regimen for ATNBC patients and the adverse effects are well-tolerated.