吉西他滨联合洛铂或顺铂治疗蒽环类和紫杉类药物耐药晚期乳腺癌的比较研究

Comparison of GL(Gemicitabine plus Lobaplatin) and GP(Gemicitabine plus Cisplatin) in the treatment of metastatic breast cancer patients with anthracycline and taxane resistance

目的:比较吉西他滨联合洛铂或顺铂治疗蒽环类和紫杉类药物耐药晚期乳腺癌的疗效和不良反应。方法:61例晚期乳腺癌患者随机分为吉西他滨加洛铂组(GL组)和吉西他滨加顺铂组(GP组)。至少治疗2个周期后分别评价疗效和不良反应发生情况。结果:GL组和GP组缓解率分别为43.33%和38.71%;GL、GP组中位肿瘤进展时间分别为6.29个月和5.59个月(P>0.05)。GL组的中性粒细胞减少、血小板减少发生率较GP组多见,而GP组的恶心呕吐发生率较GL组多见,两组间有统计学差异(P<0.05)。结论:GL和GP方案均为治疗蒽环类和紫杉类药物耐药晚期乳腺癌的有效方案,两组缓解率及中位肿瘤进展时间相近。但GL组的血液学毒性发生率较GP组多见,而GP组的胃肠道反应较GL组多见。这两种方案可能适合不同人群,值得临床进一步研究。

To evaluate the efficacy and adverse reactions of Gemieitabine / Lobaplatin （GL regimen） and Gemieitabine / Cisplatin （ GP regimen） in the treatment of metastatic breast cancer patients with anthraeyeline and taxane re- sistance. A total of sixty-one pa- tients with metastatic breast cancer were ran- domly assigned to receive the regimen of GL （n ：30） or GP （n：31）. GL regimen： Gemicit-abine 1000 mg /m2 by infusion on dl,d8,Loba- platin 30 mg /m2 on dl. GP regimen： Gemicit- abine 1000 mg/m2 by infusion on dl,d8,Cispla- tin 25 mg/m2 by infusion on dl--3. All the pa- tients had failures and relapse after previous treatment with anthracycline and taxane. Twen- ty-one days was a cycle in the both two groups. Every patient was administered at least 2 cycles. RESULTS：The overall response rate（CR＋PR） was 43.33% in GL regimen group and 38.71% in GP regimen group （P） 0.05）. The median time to progression （mTTP） in group GL andGP was 6.29 months and 5.59 months（P 0.05）. There were more neutropenia and throm- bocytopenia in the group GL, and more nausea and vomiting in the group GP. There were sig- nificant differences between the two groups（P〈 0.05）. CONCLUSION： Both GL regimen and GP regimen are well effective for patients with an-thracycline and taxane resistant metastatic breast cancer. And the response rate, median time to tumor progression were similar in both groups. The reaction of hematologic toxicity in the group GL was obviously higher than the group GP,but the gastrointestinal tract reaction was obviously higher in the group GP than the group GL. The two schemes may be suitable for different groups of people. And it is worthy of further clinical study.