吉西他滨联合顺铂治疗蒽环类或紫杉类治疗后转移性乳腺癌的疗效观察

Clinical Observation of Combination of Gemcitabine and Cisplatin for Metastatic Breast Cancer Patients Previously Treated with an Anthracycline/ Taxane-based

目的探讨吉西他滨联合顺铂治疗既往经蒽环类或紫杉类辅助治疗后发生转移的乳腺癌的疗效及不良反应。方法对86例经蒽环类或紫杉类治疗后转移的乳腺癌患者的治疗方案为:吉西他滨1 000 mg/m2,第1、8天;顺铂25 mg/m2,第1～3天;21d为1个疗程,2个疗程后评价疗效。结果 86例中总有效率(CR+PR)为48.8%,包括完全缓解(CR)6例(7.0%),部分缓解(PR)36例(41.9%),稳定(SD)28例(32.6%),进展(PD)16例(18.6%)。中位疾病进展时间(TTP)为7个月(95%可信区间:5.8～8.2个月),中位生存期(OS)为25个月(95%可信区间:18.1～31.9个月),主要治疗相关不良反应为骨髓抑制和胃肠道反应。结论吉西他滨联合顺铂是治疗蒽环类或紫杉类治疗后转移性乳腺癌的有效方案,患者对其不良反应可以耐受。

Objective To investigate the efficacy and toxicities of gemcitabine combined with cisplatin for patients with metastatic breast cancer previously treated by anthracycline/ taxane-based chemotherapy.Methods 86 cases of metastatic breast cancer were treated with gemcitabine and cisplatin.Gemcitabine 1 000mg/m2 was given intravenous on d1,8,and cisplatin 25 mg/m2 was given intravenous on d1～3 and repeated every 3 weeks.The clinical response was assessed after two cycles.ResultsOf the 86 patients,the overall response rate（OR） was 48.8%,including 6 cases（7%） complete response（CR） and 36 cases（41.9%） partial response（PR）.The numbers of stable disease and progressive disease were 28 cases（32.6%）,16 cases（18.6%）,respectively.The median time to progression（mTTP）was 7 months（95% C.I.5.8~8.2 months）,and median overall survival（mOS）was 25 months（95% C.I.18.1～31.9 months）.The main treatment-related adverse events were bone marrow inhibition and enterogastric reaction.Conclusion Combination gemcitabine and cisplatin is an effective therapy for metastatic breast cancer received adjuvant chemotherapy with an anthracycline/ taxane-based.The toxicity profile was acceptable.