依托泊苷胶囊联合孕酮治疗多程化疗和内分泌治疗耐药的晚期乳腺癌疗效及毒性分析

Chemo-endocrine of etoposide and medroxyprogesterone acetate(VMA regimen) in the treatment of heavily pretreated metastastic breast cancer:efficacy and toxicity

目的:化疗和内分泌治疗在转移性乳腺癌中通常序贯使用,依托泊苷(VP-16)及孕激素单独使用对乳腺癌都有效,但两者联合使用是否合理上午文献报道。方法:回顾性分析24例在中国医学科学院肿瘤医院接受依托泊苷(VP-16)及甲羟孕酮口服(VMA方案)的转移性乳腺癌。分析该方案的疗效和安全性。结果:VMA方案取得了33.3%的客观有效率,包括1例完全缓解和7例部分缓解。临床获益率为66. 6%, 8例稳定的患者稳定超过半年。中位无进展时间为13.7个月(11.6～23.5个月),中位总生存27.5个月(25.5～32.8个月)。绝大多数的不良事件为Ⅰ或Ⅱ度。没有发现能够预测VMA方案疗效的预测因子和预后因子。结论:尽管化疗和内分泌治疗很少同时使用,在有选择性的既往多程治疗后的转移性乳腺癌患者,依托泊苷胶囊和甲羟孕酮联合使用是一个有效、耐受性良好的选择。

Objective Chemotherapy and endocrine therapy were usually sequentially used in metastatic breast cancer patients,etoposide and medroxyprogesterone acetate are itself alone effective in breast cancer,little is known about their combination.Methods A toral of 24 metastatic breast cancer patients receiving etoposide and medroxyprogesterone acetate（VMA） in Cancer Hospital Chinese Academy of Medical Sciences were retrospectively reviewed. Response,survival and toxicity were analyzed.Results VMA regimen achieved an objective response rate of 33.3% including one CR and 7 PR. Clinical benefit rate was 66.6% （16/24）with 8 cases of stable disease more than 6 months.Median PFS was 13.7months （11. 6-23.5 months） and median OS was 27.5months（25.5-32. 8 months）respectively. Majority of adverse events were grade Ⅰ or Ⅱ,no serious adverse events were observed. No predictive factor and prognostic factor were found in patients receiving VMA regimen.Conclusion Although chemotherapy and endocrine therapy were seldomly used concurrently,in selected pretreated metastastic breast cancer patients,the combination of oral etoposide and medroxyprogesterone acetate can be considered as an effective and well tolerated choice.