卡培他滨联合多西他赛治疗蒽环类耐药性乳腺癌的临床研究

Study on the treatment effect of capecitabine and docetaxel on anthracyclines resistant breast cancer

目的：研究卡培他滨联合多西他赛对蒽环类耐药性乳腺癌的临床治疗效果，为该病的治疗提供依据。方法回顾性分析2013年1月至2015年1月就诊的100例蒽环类耐药性乳腺癌患者的临床资料，按治疗方法不同分为两组，联合使用卡培他滨与多西他赛治疗（治疗组）患者51例，单纯使用多西他赛治疗（对照组）患者49例。观察两组 KPS 评分、1年生存率、肿瘤进展时间（TTP）以及中位生存期（MST）等指标，并对其治疗有效性与安全性进行比较。结果（1）治疗前，治疗组、对照组 KPS 评分分别为（83．6±1．6）分、（83．4±1．7）分，两组差异无统计学意义（t ＝0．606，P ＞0．05）；治疗后，治疗组、对照组 KPS 评分分别为（89．5±1．2）分、（86．4±1．6）分，治疗组评分明显高于对照组（t ＝10．989，P ＜0．05）。（2）治疗后，治疗组1年生存率、TTP 以及 MST 等指标明显优于对照组[1年生存率：62．74％比40．82％，χ2＝4．815，P ＜0．05；TTP：（8．5±1．1）个月比（6．3±1.2）个月，t ＝9．563，P ＜0．05；MST：（15．6±1．2）个月比（15．6±1．2）个月，t ＝10．871，P ＜0．05]。（3）治疗组有效率、临床获益率均明显高于对照组（有效率：90．19％比63．27％，χ2＝10．234，P ＜0.05；临床获益率：94．12％比73．47％，χ2＝6．466，P ＜0．05）。（4）两组间各种不良反应发生率差异无统计学意义（骨髓抑制：13．73％比12．24％，χ2＝0．048，P ＞0．05；恶心呕吐：11．76％比14．29％，χ2＝0．104，P ＞0.05；便秘：19.61％比18．37％，χ2＝0．025，P ＞0．05；脱发：21．57％比20．41％，χ2＝0．020，P ＞0．05；消化不良：25.49％比22．45％，χ2＝0．127，P ＞0．05；关节疼痛：15．67％比20．41％，χ2＝0．378，P ＞0．05）。结论蒽环类耐药性乳腺癌患者联合使用卡培他滨与多西他赛进行治疗，能缓解患者病情，延长生存时间，治疗安全有效。因此，该方法在临床上具有进一步使用和推广的价值。

Objective To study the treatment effects of capecitabine and docetaxel on anthracyclines resistant breast cancer,so as to provide the evidence for the effective treatment of the disease.Methods 1 00 patients with anthracyclines resistant breast cancer were treated in our hospital from January 201 3 to January 201 5,and they were considered as research subjects in this study.The clinical data were analyzed retrospectively.Capecitabine and docetaxel were used for treatment in the treatment group （n =51 ）,and there were 49 cases treated with docetaxel in the control group.The indexes were observed including KPS score,the rate of survive to 1 year,TTP and MST.The treatment effects and safety were also compared in these two groups.Results （1 ）Before treatment,KPS scores in the treatment group and the control group were （83.6 ±1 .6）points and （83.4 ±1 .7）points respectively,and the difference was not statistically significant （t =0.606,P 〉0.05）.After treatment,the KPS scores were （89.5 ±1 .2）points and （86.4 ±1 .6）points,which of the treatment group was significantly higher than the control group （t =1 0.989,P 〈0.05）.（2）After treatment,1 year survival rate,TTP and MST in the treatment group were significantly higher than those in the control group[1 years survival rate：62.74% vs.40.82%,χ2 =4.815,P 〈0.05;TTP：（8.5 ±1 .1 ）months vs.（6.3 ±1 .2）months,t =9.563,P 〈0.05;MST：（1 5.6 ±1 .2）months vs.（1 5.6 ±1 .2）months,t =1 0.871 ,P 〈0.05].（3）The treatment efficiency and the clinical benefit rate in the treatment group were significantly higher than＆nbsp;those in the control group （the treatment efficiency：90.1 9% vs.63.27%,χ2 =1 0.234,P 〈0.05;clinical benefit rate：94.1 2% vs.73.47%,χ2 =6.466,P 〈0.05）.（4）However,there was no difference about the ratio of adverse reaction between the two groups （bone marrow suppression：1 3.73% vs.1 2.24%,χ2 =0.048,P 〉0.05;nausea and vomiting：1 1 .76% vs.1 4.29%,χ2 =0.1 04,P 〉0.05;constipation：1 9.61 % vs.1 8.37%,χ2 =0.025,P 〉0.05;alopecia：21 .57% vs.20.41 %,χ2 =0.020,P 〉0.05;indigestion：25.49% vs.22.45%,χ2 =0.1 27,P 〉0.05;joint pain：1 5.67% vs.20.41 %,χ2 =0.378,P 〉0.05 ）.Conclusion Capecitabine and docetaxel are used in the treatment of anthracyclines resistant breast cancer,and it can delay the patients＇condition and improve the survival time.Besides,it is also safe and effective.Therefore,this method is worth to promote and use in clinic.