表阿霉素联合紫杉醇治疗转移性三阴性乳腺癌的临床疗效及安全性评价

Clinical efficacy and safety of epirubicin combined with paclitaxel in the treatment of metastatic triple negative breast cancer

目的探讨表阿霉素联合紫杉醇治疗转移性三阴性乳腺癌的疗效及安全性。方法将110例转移性三阴性乳腺癌患者按照治疗方案不同分为单药组(52例)和联合组(58例),单药组患者于1d,8d,15d接受白蛋白结合型紫杉醇150mg/m^2治疗;联合组患者于1d,8d接受白蛋白结合型紫杉醇100mg/m^2治疗,同时于1d接受表阿霉素70mg/m^2治疗。两组均以28d为1个周期,共化疗2~4个周期。治疗周期结束后评价近期疗效和毒副作用,随访评估患者无进展生存期(PFS)。结果联合组客观缓解率(ORR)为68.97%,明显高于单药组的46.15%(P<0.05)。联合组患者白细胞下降、血红蛋白减少及恶心呕吐发生率均明显低于单药组(P<0.05);两组患者血小板减少、心脏毒性、肝功能异常及肾功能异常发生率比较差异无统计学意义(P>0.05)。所有患者中位随访时间8个月(3~40个月),单药组及联合组中位PFS分别为6个月、9个月,差异有统计学意义(P<0.05)。结论表阿霉素联合紫杉醇治疗转移性三阴性乳腺癌临床疗效显著,且毒副作用小,可耐受性好,具有良好的临床应用前景。

Objective To investigate the efficacy and safety of epirubiein combined with paelitaxel in the treatment of metastatic triple negative breast cancer. Methods Total of 110 patients with metastatic triple negative breast cancer were divided into single drug group （52 eases） and combined group （58 eases） according to the different treatment. The patients of single drug group received the therapy of nab-paelitaxel 150mg/m^2 at 1d, 8d, 15d, and combined group received the therapy of nab-paelitaxel 100mg/m^2 at 1d, 8d, at the same time received epirubiein 70mg/m^2 treatment at ld. The patients of two groups were treated for 28d as 1 cycle, a total of 2~4 cycles of chemotherapy. The efficacy and toxicity of two groups after the end of the treatment cycle were evaluated, and patients were followed for evaluation of progression free survival （PFS）. Results The objective remission rate （ORR） of the combined group was 68.97%, which was significantly higher than that of the single drug group （46.15%） （P〈0.05）. The incidence of white blood cells decreasing, hemoglobin decreasing and nausea and vomiting in patients of combined group was significantly lower than that of the single drug group （P〈0.05）. There were no significant differences in the incidence of thromboeytopenia, cardiac toxicity, liver dysfunction and renal dysfunction between the two groups （P〉0.05）. The median follow-up time of all patients was 8 months （3~40 months）. The median PFS in the single and combined groups were 6 months and 9 months, respectively, and the difference was statistically significant （P〈0.05）. Conclusion Epirubiein combined with paelitaxel in the treatment of metastatic triple negative breast cancer is effective, and has low toxicity, good tolerability and good prospects for clinical application.