多西他赛解救治疗不同年龄组转移性乳腺癌的临床研究

Clinical study of docetaxel in the treatment of metastatic breast cancer in different age groups

目的评估多西他赛解救治疗不同年龄组转移性乳腺癌患者的临床疗效及血液学毒性。方法回顾性分析3个年龄组单药多西他赛解救治疗转移性乳腺癌患者的临床资料,对临床疗效等进行统计分析。结果≤45岁年龄组的客观缓解率(Objective reponse rate,ORR)和临床获益率(Clinical benefit rate,CBR)分别为30.6%和38.7%,46~59岁年龄组ORR和CBR分别为27.6%和35.7%,而≥60岁年龄组ORR和CBR分为20.0%和27.5%。三组中位无进展生存期(Progression free survival,PFS)分别为6.0(2.9~9.1)个月、5.0(2.9~7.1)个月及4.0(3.3~4.7)个月,三年龄组ORR、CBR及PFS均无统计学差异(P=0.477,0.492,0.460)。多因素COX回归分析显示不同年龄组多西他赛解救治疗PFS与临床分期、病理类型、同侧腋窝淋巴结转移数目、无病生存期、单位体表面积剂量、解救治疗线数、复发转移部位数目等因素均无关。血液学毒性主要表现为白细胞及中性粒细胞减少,多西他赛对血红蛋白及血小板影响较小。结论多西他赛临床疗效及血液学毒性与年龄有一定程度的相关,随着年龄的增加,显现出临床疗效降低,血液毒性加重的趋势。

Objective The aim of this study was to evaluate the clinical efficacy and hematologic toxicity of docetaxel in the treatment of metastatic breast cancer patients in different age groups.Methods The clinical data of three groups of single-agent docetaxel in the treatment of metastatic breast cancer patients were retrospectively analyzed.The clinical efficacy of docetaxel was analyzed statistically.Results The objective response rate(ORR)and clinical beneficial rate(CBR)in the group of age<=45 year group were 30.6% and 38.7%,and the ORR and CBR in the 46~59 age were 27.5% and 35.7%,while ORR and CBR in the ≥60 age group were 20.0% and 27.5%.The median progress free survival(PFS)in three groups was 6.0(2.9~9.1)months,5.0(2.9~7.1)months and 4.0(3.3~4.7)months,respectively.There was no statistical difference in three different age groups(P=0.477,0.492 and 0.460,respectively).Cox regression analysis showed that the docetaxel rescue treatment of PFS had not associated with clinical stage,pathological type,ipsilateral axillary lymph node metastasis,disease free survival,unit dose of body surface area dose,number of rescue treatment lines,number of recurrence and metastasis,etc.in three different age groups of patients with metastatic breast cancer.Hematological toxicity was mainly manifested by a decrease in white blood cells and neutrophils,and docetaxel has less effect on hemoglobin and platelets.Conclusion The clinical efficacy and hematologic toxicity of docetaxel have a certain degree of correlation with ages.With the increase of age,the clinical curative effect is reduced and the blood toxicity is aggravated.