节拍CMX方案一线治疗晚期三阴型乳腺癌的临床研究

A Clinical Study on Metronomic CMX Program in the First Line Treatment of Terminal Triple Negative Breast Cancer

目的探讨节拍CMX方案二线治疗晚期三阴型乳腺癌（TNBC）的疗效。方法纳入2013年1月至2015年12月我院住院治疗的80例晚期TNBC患者,采用电脑随机分为两组。试验组40例,采用节拍CMX方案化疗;对照组40例,采用吉西他滨＋铂类（GP）方案化疗。比较两组患者治疗有效率、无进展生存期及毒副反应。结果试验组治疗有效率为57.5%,对照组治疗有效率为40.0%,试验组有效率高于对照组,但两组患者总有效率比较差异无统计学意义（P〉0.05）。试验组无进展生存期2-16.8个月,中位无进展生存期7.3个月;对照组无进展生存期1-15.9个月,中位无进展生存期6.2个月,两组相比差异有统计学意义（P〈0.05）。试验组骨髓抑制Ⅲ度及以上反应者6例（15.0%）;对照组骨髓抑制Ⅲ度及以上反应者15例（37.5%）,两组比较发生率差异有统计学意义（P〈0.05）。试验组Ⅱ度以上胃肠道反应者10例（25.0%）,对照组Ⅱ度以上胃肠道反应者24例（60%）,两组比较发生率差异有统计学意义（P〈0.05）。试验组手足综合征发生多为Ⅰ-Ⅱ级,共3例（7.5%）,对照组手足综合症0例,两组比较发生率差异有统计学意义（P〈0.05）。结论采用持续或短间歇的节拍化疗方案治疗TNBC,低毒、有效。

Objective To explore the efficacy of metronomic CMX program in the treatment of terminal triple negative breast cancer（ TNBC）. Methods 80 cases of terminal TNBC patients received treatment from January 2013 to December 2014 in our hospital were included and randomly divided into two groups according to computer. 40 cases in the experimental group,received metronomic CMX chemotherapy and 40 patients in the control group,received gemcitabine plus platinum（ GP） chemotherapy. The response rate,progression-free survival（ PFS）,toxic and side effect of the two groups were compared. Results The response rate of experimental group 57. 5% was higher than the response rate of control group 40%,but there was no statistically significant difference（ P〈0. 05）. The PFS of experimental group was 2-16. 8 months and the median PFS was 7. 3 months. The PFS of control group was 1-15. 9 months and the median PFS was 6. 2 months. The difference between two groups was statistically significant（ P〈0. 05）. There were 6 cases of Ⅲ degree or above myelosuppression in experimental group,accounting for 15% and 15 cases of Ⅲ degree or above myelosuppression in control group,accounting for 37. 5%,the incidence difference between the two groups being statistically significant（ P〈0. 05）. There were 10 cases of II degree above gastrointestinal reaction in experimental group,accounting for 25% and 24 cases of II degree above gastrointestinal reaction in control group,accounting for 60%,the incidence difference between the two groups being statistically significant（ P〈0. 05）. The 3 cases of hand-foot syndrome occurred in experimental group were mostly I-II degree,accounting for 7. 5% and the 0 cases of hand-foot syndrome occurred in control group the incidence difference between the two groups being statistically significant（ P〈0. 05）. Conclusion Adopting continuous or short-intermittent metronomic chemotherapy treating TNBC is of low toxicity and high effectivity.