紫杉醇序贯化疗治疗乳腺癌患者疗效及毒副反应分析

Analysis of curative effect and toxic and side effects by sequential chemotherapy of paclitaxel in the treatment of breast cancer patients

目的分析紫杉醇序贯化疗治疗乳腺癌患者的疗效及毒副反应。方法 80例乳腺癌患者,依据随机数字表法将患者分为观察组和对照组,各40例。对照组患者采用4个周期的CEF100化疗方案,观察组患者在对照组基础上接受4个周期的序贯多西紫杉醇化疗。对比两组患者的疾病缓解情况,观察毒副反应发生情况。结果观察组完全缓解(CR)25例(62.5%),部分缓解(PR)11例(27.5%),稳定(SD)3例(7.5%),进展(PD)1例(2.5),总有效率(OR)为90.0%;对照组CR9例(22.5%),PR17例(42.5%),SD14例(35.0%),PD0例,OR为65.0%;观察组OR高于对照组,差异有统计学意义(P<0.05)。观察组6例患者在序贯多西紫杉醇化疗期间出现Ⅲ级及以上中性粒细胞减少症,采用G-CSF对症治疗后缓解;7例患者出现Ⅱ级血小板、白细胞减少反应。非造血系统毒性反应分别为脱发、恶心呕吐、肌肉关节疼痛、口腔黏膜、乏力,未出现心脏毒性和神经系统毒性反应。结论多西紫杉醇序贯化疗可提高治疗乳腺癌的疗效,且安全性性高。紫杉醇序贯化疗期间应重点做好血液学毒性预防工作,减少毒副反应。

Objective To analyze curative effect and toxic and side effects by sequential chemotherapy of paclitaxel in the treatment of breast cancer patients. Methods A total of 80 patients with breast cancer were divided by random number table into observation group and control group, with 40 cases in each group. The control group received CEF100 chemotherapy regimen for 4 courses, and the observation group also received additional sequential chemotherapy of paclitaxel for 4 courses on the basis of the control group. Comparison was made on disease remission condition between the two groups, and observation was made on toxic and side effects in the two groups. Results The observation group had 25 complete remission（CR） cases（62.5%）, 11 partial remission（PR） cases（27.5%）, 3 cases with stable disease（SD）（7.5%） and 1 case with progress disease（PD）（2.5%）, with total objective remission（OR） rate as 90.0%. The control group had 9 CR cases（22.5%）, 17 PR cases（42.5%）, 14 SD cases（35.0%）, and 0 PD case, with OR rate as 65.0%. The observation group had higher OR than the control group, and the difference had statistical significance（P〈0.05）. There were 6 cases with neutrophilic granulocytopenia above grade Ⅲ during sequential chemotherapy of paclitaxel, and they were relieved by symptomatic G-CSF treatment. There were 7 cases with grade Ⅱ thrombocytopenia and leucopenia. Non-hematopoietic system toxic reactions included baldness, nausea and vomiting, muscular and joint pain, oral mucosa, and feeble. There were no cardiotoxicity and nervous system toxic reactions. Conclusion Sequential chemotherapy of paclitaxel can improve curative effect in the treatment of breast cancer patients, along with high safety. It is necessary to provide specific prevention of hematological toxicity during sequential chemotherapy of paclitaxel for toxic and side effects reduction.