多西他赛联合卡铂二、三线治疗晚期三阴乳腺癌临床观察

Clinical observation of docetaxel combined with carboplatin as second -or third -line treatment for patients ;with advanced triple -negative breast cancer

目的：观察多西他赛联合卡铂21 d 方案（TC 方案）二、三线治疗转移性三阴乳腺癌（ATNBC）患者的疗效和不良反应。方法37例蒽环类耐药的晚期 ATNBC 患者，多西他赛70 mg／m2，第1天静脉滴注；卡铂曲线下面积（AUC）＝5，第1天静脉滴注，21 d 为1个疗程，直到疾病进展或无法耐受或最多接受6个周期化疗。结果37例患者共完成147个周期化疗，中位化疗周期为4个周期。均可评价疗效和不良反应。其中完全缓解（CR）0例，部分缓解（PR）12例（32．43％），稳定（SD）11例（29．73％），进展14例（PD）（41.18％）。有效率（RR ＝CR ＋PR）为32．43％，疾病控制率（CR ＋PR ＋SD）为62．15％，中位疾病进展时间（TTP）3．9个月（95％CI：4～8个月），中位总生存时间（OS）10．0个月，至随访结束，仍有3例患者无进展生存。治疗后主要不良反应为血液学毒性（白细胞减少51．53％）和消化道反应（56．76％）。结论TC 方案治疗晚期 ATNBC 患者安全有效，不良反应可以耐受。

Objective To observe the clinical efficacy and adverse reactions of docetaxel and carboplatin 21 day regimen （TC）as second -or third -line in treatment of patients with advanced triple -negative breast cancer （ATNBC）.Methods 37 ATNBC patients with anthracyclines resistance were given docetaxel 70mg/m2 ,the first day of intravenous drip,carboplatin AUC =5,through intravenous drip on the first day,21 days for a course of treatment, until disease progression or not tolerated or most received six cycles of chemotherapy.Results 147 cycles of chemo-therapy were completed in 37 patients,and the median chemotherapy cycle was 4 cycles.The efficacy and adverse reactions could be evaluated in all patients.Among them,complete remission （CR）in 0 patient,partial remission （PR）in 12 patients （32.43%）,stable （SD）in 11 patients （29.73%）,and progression （PD）in 14 patients （41.18%）.The effective rate（CR ＋PR）was 32.43%.The disease control rate （CR ＋PR ＋SD）was 62.15%,median TTP was 3.9 months （95%CI：4 -8months）,and median OS was 10 months.Until the end of follow -up,there were 3 patients with no progress.The main adverse reactions were hematological toxicity （51.53%）and gastrointestinal reaction （56.76%）.Conclusion TC regimen is effective and safe in the treatment of patients with ATNBC.