培美曲塞联合替吉奥治疗晚期乳腺癌的效果观察

Clinical effects of Pemetrexed combined tegafur in the treatment of advanced breast cancer

目的探讨培美曲塞联合替吉奥方案治疗紫杉类、蒽环类耐药晚期乳腺癌的近期效果及不良反应。方法对26例经蒽环类和紫杉类药物治疗失败的晚期乳腺癌患者采用培美曲塞联合替吉奥方案治疗，培美曲塞500mg／m^2静脉滴注，第1天；替吉奥80mg／（m^2·d），分2次餐后30min口服，第1～14天，3周为1周期，至少应用2周期，治疗结束2周后评定疗效。结果入组26例均可评价疗效，治疗后完全缓解3例（11．5％）、部分缓解9例（34．6％）、稳定5例（19．2％）、进展9例（34．6％），总有效率为46．2％（12／26），肿瘤控制率65．3％（17／26）。无严重不良事件发生，无一例死亡，主要的不良反应为骨髓抑制、恶心、呕吐、皮疹和肝功能损害。结论培美曲塞联合替吉奥方案治疗蒽环类及紫杉类治疗失败的晚期转移性乳腺癌患者效果显著，不良反应较轻，患者均可以耐受。

Objective To evaluate the efficacy and toxicity of anthracycline and taxane combination regimen in the treatment of advanced breast cancer in patients who were previously treated with anthraeycline and taxane. Methods Twenty-six patients who previously failed to respond to anthraeycline and taxane based chemotherapy received pemetrexed and tegafur combination regimen （ pemetrexed ： 500 mg/m2, ivgtt on the first day; tegafur： 80 mg/（m2 . d） ,twice daily during day 1 - 14）. The regimen was repeated at least two cycles of three weeks each and the clinical response was recorded at two weeks after treatment. Results Of the 26 patients,he tumor control rate was 65.3% （17/26）, and the overall response rate was 46. 2% （12/26） , including 3 patients with complete remission and 9 patients with partial remission. The symptoms were stable in 5 patients and improved in 9 patients. There was no severe complications or death observed. The most frequent treatment-related adverse events were myelosuppression, nausea, vomitting, rash and hepatic function impairment. Conclusion Pemetrexed combined with tegafur in the treatment of patients with advanced metastatic breast cancer who did not respond to anthracycline and taxane treatment is effective with minimal adverse reactions and can be tolerated by patients.