培美曲塞联合顺铂治疗晚期乳腺癌36例疗效分析

Clinical analysis of pemetrexed combined with cisplatin on 36 patients with advanced breast cancer

目的 探讨培美曲塞联合顺铂治疗晚期乳腺癌36例临床疗效.方法 研究对象为2010年6月至2012年6月本院收治的36例晚期乳腺癌患者.静脉滴注培美曲塞二钠500mg/m2,d1；顺铂25mg/m2,d1～d3.21天为1个周期.每个患者至少治疗2个疗程后评价疗效和不良反应.结果 36例患者,CR 0例,PR 7例（19.4％）,SD 17例（47.2％）,PD12例（33.3％）,总有效率为19.4％ （7/36）,临床获益率为66.7％ （24/36）.主要不良反应为骨髓抑制,20例表现为白细胞减少（Ⅰ～Ⅱ级）,占55.6％.其他不良反应还包括疲乏21例,占58.3％；皮疹17例,占47.2％例；恶心、呕吐15例,占41.7％.结论 培美曲塞联合顺铂方案治疗蒽环类和紫杉类化疗失败的转移性乳腺癌有较好的疗效,患者耐受性好,值得临床进一步研究.

Objective To explore the clinical effect of pemetrexed combined with cisplatin on 36 patients with advanced breast cancer. Methods Thirty - six patients with advanced breast cancer admitted from June,2010 to June,2012 in our hospital were in- travenously given 500mg/m2 pemetrexed disodium on dl and 25mg/m2 cisplatin on dl - d3,21 days were considered as a course. Clinical effect and adverse reactions were evaluated after at least 2 courses in both groups. Results Of the 36 patients,there were 0 CR,7 PR, 17 SD and 12 PD ,with total effective and clinical benefit rate being 19. 4% （7/36）and 66. 7% （24/36）, respectively. Major adverse reactions are bone marrow suppression including 29 leukopenia （55.6%） , and other ones like 21 fatigue （58. 3% ） , 17 rash （47. 2% ） ,and 15 nausea and vomiting （41.7%）. Conclusion Pemetrexed combined with cisplatin have remarkable effect and favorable drug -tolerance on metastatic breast cancer poor in antharcycline and taxanes, deserving to be promoted in clinic.