长春瑞滨联合洛铂或顺铂治疗晚期乳腺癌的对比分析

Comparison of vinorelbine plus lobaplatin or cisplatin in the treatment of advanced breast cancer

目的:观察洛铂联合长春瑞滨(NL方案)或顺铂联合长春瑞滨(NP方案)对蒽环及紫杉类药物治疗失败的晚期转移性乳腺癌的疗效及不良反应。方法:对39例确诊为蒽环类、紫杉类治疗失败的晚期转移性乳腺癌患者随机分为NL方案组或NP方案组治疗。NL方案组20例,长春瑞滨(NVB)25mg/m2,静脉滴入,d1,d8;洛铂(LBP)30mg/m2,静脉滴入,d1。NP方案组19例,NVB 25mg/m2,静脉滴入,d1、d8;顺铂(DDP)30mg/m2,静脉滴入,d1～d3。21d为1个周期,至少2个周期。结果:39例患者均可评价疗效,NL组总有效率(RR)为60%(12/20),NP组为47.4%(9/19),两组比较差异无统计学意义,P>0.05;中位疾病进展时间(TTP)NL组为94d,NP组为128d,两组比较差异无统计学意义,P>0.05。主要不良反应为骨髓抑制和胃肠道反应,NP组患者恶心、呕吐发生率明显高于NL组,P<0.05;但白细胞减少及血小板减少发生率差异无统计学意义,P>0.05。结论:对蒽环、紫杉类耐药的晚期乳腺癌,NL方案是一个安全、有效的化疗方案。

OBJECTIVE： To observe the efficacy and adverse effects of lobaplatin plus vinorelbine （NL） and cisplatin plus vinorelbine （NP） in the treatment of advanced metastatic breast cancer with failure of the first line treatment of an thracyclines and taxanes. MEHTODS：Thirty-nigh patients with advanced metastatic breast cancer were randomly divided into two groups of NL or NP chemotherapy. Twenty patients of NL received vinorelbine 25 mg/m2 on day 1 and 8,with lobaplatin 30 mg/m2 on day 1. Nineteen patients of NP received vinorelbine 25 mg/m2 on day 1 and 8, and cisplatin 30 mg/m2 on day 1 to 3. 21 days was one cycle,for at least 2 cycles. RESULTS： All 39 patients could be evaluated,the o verall response rate was 60.0%（12/20） in NL,and 47.4%（9/19） in NP. The median time to progression was 128 days in NP,and 94 days in NL. No significant difference was identified in two groups,PD0.05. The main side effects were my elosuppression,gastrointestinal reactions. The nausea and vomiting in group NP was higher than that in group NL （P〈0.05） ,but there was no significant difference between the two groups in the decrease of white blood cells and platelets （P〉0.05）. CONCLUSION： Lobaplatin plus vinorelbine is a safe and effective treatment regimen for advanced breast cancer.