伊立替康联合培美曲塞治疗难治性乳腺癌疗效观察

Effect of irinotecan combined with pemetrexed on refractory breast cancer

目的探讨伊立替康联合培美曲塞治疗难治性乳腺癌的疗效及安全性。方法难治性乳腺癌患者29例,给予伊立替康180mg/m^2+生理盐水250mL,第1天,60min静脉滴注完毕;培美曲塞500mg/m^2+生理盐水100mL,第1天,15min静脉滴注完毕;每21d为1个周期。每2个周期评定疗效和不良反应,至出现无法耐受的不良反应停药,最多化疗6个周期。随访观察生存时间,计算1a生存率。结果 29例患者共完成117个周期化疗,总有效率为34.5%,疾病控制率为55.2%;中位无进展生存期为6.1个月,1a生存率为51.7%;不良反应以Ⅰ~Ⅱ度为主,Ⅲ~Ⅳ度中性粒细胞计数减少、血红蛋白减少、血小板计数减少、腹泻、恶心呕吐发生率分别为10.3%、6.90%、3.45%、10.3%、3.45%,无治疗相关性死亡。结论伊立替康联合培美曲塞治疗难治性乳腺癌效果较好,不良反应轻。

Objective To observe the effect and toxicity of irinotecan combined with pemetrexed in the treatment of refractory breast cancer. Methods Twenty-nine cases of refractory breast cancer received intravenous injection of irinotecan 180 mg/m^2 in 250 mL normal saline within 60 minutes and pemetrexed 500 mg/m^2 in 100 mL normal saline within 15 rain by day 1, with 21 d as one cycle. The patients were stopped chemotherapy until the adverse reaction was intolerable. The effect and adverse reactions were evaluated every two cycles. All patients received not more than 6 cycles. The survival time was followed up and the 1-year survival rate was calculated. Results A total of 29 patients completed 117 cycles of chemotherapy, with total effective rate of 34. 5% , and disease control rate of 55. 2%. The median progression-free survival was 6.1 months. One-year survival rate was 51.7%. The adverse reactions were mainly in Ⅰ to Ⅱ degree. The incidences of grade Ⅲ to Ⅳ degree of granulocytopenia, decreased hemoglobin, decrease of platelet count, diarrhea, and nausea and vomiting were respectively 10.3%, 6.90%, 3.45%, 10.3% and 3.45%. No treatment related death occurred. Conclusion Irinotecan combined with pemetrexed can achieve satisfactory results for refractory breast cancer, with mild adverse reactions.