DC方案与DE方案一线治疗转移性乳腺癌的对比研究

Comparison of two first-line chemotherapy regimens(docetaxel plus capecitabine versus docetaxel plus epirubicine) for patients with metastatic breast cancer

目的比较多西紫杉醇联合卡培他滨（DC方案）与多西紫杉醇联合表柔比星（DE方案）一线治疗转移性乳腺癌的疗效及不良反应。方法 65例转移性乳腺癌患者分别接受DC方案和DE方案治疗。DC方案组：多西紫杉醇75mg/m2静滴,d1;卡培他滨2000mg/（m2.d）,分两次口服,d1~d14。DE方案组：多西紫杉醇75mg/m2静滴,d1;表柔比星75mg/m2静推,d1。两方案均以21天为1个周期。结果 DC方案组有效率高于DE方案组（60.6%vs.46.9%,P〉0.05）,其中DC方案组完全缓解率高于DE方案组（24.2%vs.6.3%）,两组比较差异有统计学意义（P〈0.05）。DC方案组的6个月后疾病无进展率（PFR）优于DE方案组（72.7%vs.62.5%,P〉0.05）。中位无进展生存期（PFS）DC方案组长于DE方案组（11.4个月vs.7.6个月）,两组比较差异有统计学意义（P〈0.05）。不良反应以骨髓抑制、胃肠道反应和脱发为主,3、4级手足综合征发生率DC方案组（27.3%,9/33）高于DE方案组（0）,差异有统计学意义（P〈0.05）。结论 DC方案及DE方案一线治疗转移性乳腺癌均取得较好疗效,DC方案可以作为非蒽环类药物有效的一线治疗方案。

Objective To evaluate the efficacy and adverse reactions of docetaxel/capecitabine（ DC regimen）and docetaxel/ epirubicin（DE regimen）as the first-line treatment of metastatic breast cancer. Methods Sixty-five patients diagnosed as metastatic breast cancer were asigned to receive DC regimen or DE regimen. DC regimen： docetaxel 75mg/m2 by infusion on d1, capecitabine 2000mg/m^2 for twice daily on d1 -d14. DE regimen： docetaxel 75mg/m^2 by infusion on dI , epimbicin 75mg/m^2 by infusion on dI. Twenty-one days was a cycle in the both two groups. Results The overall response rate was 60. 6% in DC regimen group and 46. 9% in DE regimen group（P 〉 0. 05 ） ; The complete response rate was 24.2% in DC regimen group and 6. 3% in DE regimen group（ P 〈 0. 05 ）. The 6-month progress free rate （PFR） were 72. 7 % in DC regimen group and 62. 5 % in DE regimen group （ P 〉 0. 05 ） , respectively. The median progress free survival（PFS） was 11.4 months in DC regimen group, which was higher than 7. 6 months in DE regimen group（P 〈 0. 05 ）. The main toxicities were myelosuppression, gastrointestinal tract reaction and alopecia. The frequency of 3/4 grade hand-foot syndrome was 27.3% in DC regimen group and 0 in DE regimen group （ P 〈 0. 05 ） , respectively. Conclusion Both DC regimen and DE regimen are effective as the first-line treatment for metastatic breast cancer. DC regimen can be regarded as the first-line non-anthracychire chemotherapy for metastatic breast cancer.