吉西他滨联合卡培他滨治疗复发转移性乳腺癌的临床观察

Clinical observation of gemcitabine combined with capecitabine in the treatment of recurrent and metastatic breast cancer

目的观察吉西他滨联合卡培他滨治疗复发转移性乳腺癌的临床疗效及不良反应。方法 32例蒽环类及紫杉类药物治疗失败的复发转移性乳腺癌患者接受吉西他滨联合卡培他滨治疗：吉西他滨1 000 mg·m-2,静脉滴注第1,8天;卡培他滨1 250 mg·m-2,口服,2次/日,第1~14天,每21 d为1周期,每2个周期评价疗效,最终观察目的为PFS及药物毒副反应。结果 32例患者中完全缓解（CR）3例,部分缓解（PR）11例,ORR为43.75%;中位PFS达7.5个月。主要不良反应为血液系统毒性：Ⅲ~IV度粒细胞减少发生率为42.5%;手足综合征发生率38.2%,胃肠道反应28.3%,无化疗相关死亡病例。结论吉西他滨联合卡培他滨治疗复发转移性乳腺癌近期疗效肯定,耐受良好,远期疗效有待进一步观察。

Objective To observe clinical efficacies and side-effects of gemcitabine combined with capecitabine in the treatment of recurrent and metastatic breast cancer. Methods 32 patients with recurrent and metastatic breast cancer who had failed in treatment of antharcycline and paclitaxel received gemcitabine plus capecitabine treatment,with gemcitabine 1 000 mg·m-2intravenous drip day 1, 8 and capecitabine 1 250 mg·m-2orally bid,day 1 ~ 14,for every 21 days. Primary end point was progression-free survival（ PFS）, and secondary end point were objective response rate（ ORR） and drug toxicity. Results Three of the 32 patients had complete remission（ CR） as the best efficacy,11 patients with partial remission（ PR）,and ORR was 43. 75%. The main adverse reaction was hematological toxicity： the incidence rate of Ⅲ ~ IV neutropenia was 42. 5%,hand-food syndrome 38. 2%,gastro-intestinal toxicity 28. 3%. And there was no chemotherapy-related death. Conclusions Gemcitabine combined with capecitabine has a certain curative effect in the treatment of recurrent and metastatic breast cancer with good tolerance. And the long-term results deserve further observation.