吉西他滨联合卡铂或顺铂对Ⅳ期三阴性乳腺癌患者疗效及生存时间的影响

Effects of gemcitabine combined with carboplatin or cisplatin in patients with three negative breast cancer(Ⅳ) on efficacy and survival time

目的研究吉西他滨联合卡铂或顺铂对Ⅳ期三阴性乳腺癌患者疾病控制率、生存时间及不良反应的影响。方法选取2013年1月至2014年12月该院接受治疗的Ⅳ期三阴性乳腺癌患者84例。采用随机数字表法分为吉西他滨联合卡铂(GC)组和吉西他滨联合顺铂(GP)组,每组42例,GC组患者采用GC治疗,GP组患者采用GP治疗,比较2组患者的临床疗效、不良反应、生存率及肿瘤进展时间。结果 GC组患者的完全缓解(CR)例数为19例(45.24%),部分缓解(PR)例数为7例(16.67%),有效率为61.90%,GP组患者的CR例数为18例(42.86%),PR例数为6例(14.29%),有效率为57.14%,两者比较差异无统计学意义(P>0.05)。GC组患者中性粒细胞减少和血小板减少发生率明显高于GP组,恶心呕吐、食欲下降等胃肠道反应的发生率低于GP组,差异有统计学意义(P<0.05);2组患者的乏力、便秘、肾毒性和肝毒性等不良反应的发生率比较差异无统计学意义(P>0.05)。2组患者1年生存率、2年生存率和中位肿瘤进展时间比较,差异无统计学意义(P>0.05)。结论 GC或GP二线治疗Ⅳ期三阴性乳腺癌的疗效相似,GC方案骨髓抑制不良的发生率较高,GP方案胃肠道不良反应的发生率较高,不良反应可耐受。

Objective To study the effect of platinum based chemotherapy in patients with three negative breast cancer（Ⅳ）on disease control rate,survival time and side effects.Methods 84 patients with three negative breast cancer（Ⅳ）who treated in the hospital were selected from January 2013 to December 2014.They were divided into GC group and GP group using a random number table method,each group had 42 cases,GC group were treated with gemcitabine combined with carboplatin,GP group were treated with gemcitabine combined with cisplatin.Compared the clinical efficacy,side effects,survival rate and tumor progression time between the two groups.Results The number of CR cases in GC group were 19 cases（45.24%）,PR was 6 cases（16.67%）,effective rate was 61.90%,the number of CR cases in GP group were 18 cases（42.86%）,PR was 7 cases（14.29%）,effective rate was57.14%,the difference had no statistical significance（P〉0.05）.GC group of patients with neutropenia and thrombocytopenia was significantly higher than that of GP group,nausea and vomiting,loss of appetite and gastrointestinal reaction rate is lower than the GP group,the difference had statistical significance（P〉0.05）,there was no significant difference in the incidence of adverse reaction of two groups of patients with fatigue,constipation,kidney toxicity and liver toxicity（P〈0.05）.There was no significant difference between the two groups in the survival rate of the patients in the 1 groups,the survival rate of the 2 years and the median tumor progression time（P〈0.05）.Conclusion The efficacy of GC regimen and GP regimen in the second-line treatment ofⅣnegative breast cancer three similar toxicity inhibition of bone marrow of GC protocol has high incidence rate,high incidence of GP gastrointestinal reaction and toxicity,the toxicity can be tolerated.