吉西他滨联合顺铂治疗晚期三阴性乳腺癌的临床疗效观察

Clinical observation of gemcitabine combined with cisplatin in treatment of advanced triple negative breast cancer

目的探讨吉西他滨联合顺铂治疗晚期三阴性乳腺癌的临床疗效。方法选取2008年1月~2012年1月我院收治的三阴性乳腺癌患者60例,随机分成治疗组和对照组各30例。治疗组予吉西他滨1000 mg/m^2,第1、8天静滴;顺铂75 mg/m2,第1天静滴;每21天为1个周期。对照组予吉西他滨1000 mg/m^2,第1、8天静滴;卡铂AUC=5第1天静滴;每21天为1个周期。每2个周期进行疗效评价。同时进行随访,比较两组患者的中位肿瘤进展时间、中位生存期及毒副反应情况。结果治疗组临床总有效率60.0%,对照组临床总有效率56.6%,两组总有效率比较,差异无统计学意义（P〉0.05）,治疗组的中位肿瘤进展时间、中位生存期与对照组比较,差异无统计学意义（P〉0.05）。治疗组患者的白细胞减少发生率33.3%、中性粒细胞减少发生率33.3%、血小板减少发生率33.3%、血红蛋白降低发生率36.7%,均显著低于对照组,但治疗组患者的恶心、呕吐发生率20.0%,显著高于对照组的6.7%,差异有统计学意义（P〈0.05）。结论吉西他滨联合顺铂治疗晚期三阴性乳腺癌的疗效确切,毒副反应少,值得推广和应用。

Objective To investigate the clinical efficacy of gemcitabine combined with cisplatin in treatment of advanced triple negative breast cancer. Methods Sixty patients with triple negative breast cancer methods from January2008 to January 2012 in our hospital,were randomly divided into treatment group and control group,30 cases in each group. Treatment group received gemcitabine 1000 mg/m2,1,8 days of intravenous,cisplatin 75 mg/m2,1st day of intravenous drip; every 21 days for 1 cycle. The control group received gemcitabine 1000 mg/m2,1,8 days of intravenous drip; carboplatin（AUC=5）,first day of intravenous drip; every 21 days for 1 cycle. The therapeutic effect was evaluated every 2 cycles. At the same time follow-up,compared two groups of patients with a median time to tumor progression,and toxicity of the median survival period. Results The clinical total effective rate in the treatment group was 60.0%,the clinical total effective rate in the control group was 56.6%, the total efficiency of two groups had no difference（P〉0.05）. The median tumor time to progression,median survival time of treatment group compared with the control group,the difference was not significant（P〉0.05）. The patients in the treatment group 33.3% incidence of leukopenia,neutropenia, thrombocy topenia occurred in 33.3% of the incidence rate of 33.3%,lower hemoglobin incidence rate of 36.7%,significantly lower than the control group, but the nausea and vomiting of patients in the treatment group（20.0%） was significantly higher than that of control group（6.7%）,there were significant differences（P〈0.05）. Conclusion The curative effect of gemcitabine combined with cisplatin in treatment of advanced three negative breast cancer is exact,little toxic side effects,and is worthy of promotion and application.