吉西他滨联合顺铂治疗晚期三阴性乳腺癌的临床观察

Clinical Efficacy and Toxicity of Gemcitabine and Cisplatin in the Second Line Treatment of Advanced Triple-negative Breast Cancer(TNBC)

目的观察吉西他滨联合顺铂二线治疗晚期三阴性乳腺癌(TNBC)的临床疗效及不良反应。方法 28例对蒽环类或(和)紫杉类耐药的晚期TNBC患者,给予吉西他滨联合顺铂化疗,具体化疗方案:吉西他滨1000 mg/m2,静脉滴注,第1,8天;顺铂20 mg/m2,静脉滴注,第1～4天。21 d为1个周期,化疗2周期以上,然后按WHO标准评价疗效和不良反应。结果 28例患者均可评价疗效,其中CR 1例(3.6%),PR 8例(28.6%),SD 15例(53.6%),PD 4例(14.3%),总有效率(CR+PR)为32.1%。随访12个月,中位生存期为6.4月。治疗主要不良反应为骨髓抑制和胃肠道反应。Ⅲ～Ⅳ度不良反应分别为中性粒细胞减少(32.1%),血小板减少(28.6%),乏力(21.4%),恶心呕吐(14.3%),贫血(7.1%)。结论吉西他滨联合顺铂方案对晚期TNBC疗效确切,安全性较好。

Objective To observe the efficacy and toxicity of gemcitabine and cisplatin in the second line treatment of advanced triple-negative breast cancer（TNBC）.Methods Twenty-eight patients with with anthracycline and taxane-resistant advanced TNBC were given gemcitabine 1000 mg/m2,day 1,8 and cisplatin 20 mg/m2,day 1-4.The patients were repeatedly treated every 21 days.The efficacy and toxicity were evaluated by standard of WHO more than 1 cycles later.Results All twenty-eight patients were available for objective response,CR 1 case,PR 8 cases,SD 15 cases,PD 4 cases,the overall response rate（CR＋PR） was 32.1%.Follow-up of 12 months,the median survival duration was 6.4 months;the main treatment-related toxicities were bone marrow depression and gastrointestinal reaction.Grade 3/4 toxicity included neutropenia 32.1%,thrombocytopenia 28.6%,fatigue 21.4%,nausea and vomiting 14.3%,and anemia 7.1%.Conclusion Our results suggest a safe and effective outcome for metastatic triple negative breast cancer patients when treated with cisplatin and gemcitabine combination chemotherapy.