长春瑞滨联合希罗达治疗蒽环类和紫杉类耐药的晚期乳腺癌临床分析

Clinical Efficacy of Vinorelbine Combined with Xeloda for Patients with Anthracycline- and Taxane-refractory Metastatic Breast Cancer

目的:观察长春瑞滨(NVB)联合希罗达(XEL)21天方案([NX]方案),治疗蒽环类和紫杉类药物耐药的转移性乳腺癌(anthracycline-and taxanerefractory metastatic breast cance,ATRMBC)患者的疗效和不良反应方法:NVB 25 mg/m^2,d1,8,快速静滴;XEL2.0g/(m^2·d),早晚2次,餐后30min口服,d1～14,21天为1个疗程,最多接受6个周期化疗或至疾病进展。结果:48例患者共完成172个周期化疗,中位化疗周期4个周期均可评价疗效和不良反应其中完全缓解(CR)0例,部分缓解(PR)11例,稳定(SD)23例,进展(PD)14例总有效率(CR+PR)22.92%,疾病控制率(DCR)70.83%,中位无进展生存期(TTP)6.7个月(1～22个月),1年生存率.32/48(66.70%),2年生存率21/48(43.75%)。治疗后主要不良反应为血液学毒性及手足综合征,其次为胃肠道反应及脉管炎。结论:[NX]方案是治疗ATRMBC的有效方案,不良反应可以耐受。

Objective： This study aims to evaluate the clinical efficacy and tolerability of a threeweek regimen of vinorelbine with xeloda for 48 patients with anthracycline and taxanerefractory metastatic breast cancer （ATRMBC）. Methods： Fortyeight pa tients with anthracycline and taxanerefractory metastatic breast cancer were enrolled in this study. All patients were given 25 mg/m2 of vinorelbine on days one, and eight, combined with 2.0 g/m2 of xeloda daily from days l to 14. The combined chemotherapy was repeat ed every 21 days as one cycle. Patients received a maximum chemotherapy of six cycles or until disease progression. Results： All 48 pa tients completed 172 chemotherapy cycles with a fourcycle median per patient. Adverse events and clinical efficacy were evaluated on all 48 patients. Complete remission （CR） was not observed in any patient, partial remission （PR） in 11 patients, stable disease （SD） in 23 patients, and progression of disease （PD） in 14 patients. The overall response rate （CR＋PR） was 22.92% and the disease control rate （DCR） was 70.83%. The median time to progression （TTP） was 6.7 months （1 month to 22 months）, 1year survival rate was 66.70%, and twoyear survival rate was 43.75%. The most commonly observed adverse events were hematologic toxicity and handfoot syn drome, followed by gastrointestinal reaction and angeitis. No mortality occurred during the treatment. Conclusion： Vinorelbine com bined with xeloda is an effective and safe chemotherapeutic regimen for ATRMBC patients; the adverse reactions are well tolerated.