卡培他滨为主的联合方案治疗晚期转移性乳腺癌
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孙国荣 E-mail:sunguorong0094@sina.com

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Capecitabine-based combination chemotherapy for metastatic breast cancer
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    摘要:

    目的:探讨以卡培他滨(希罗达)为主的联合化疗方案治疗转移性乳腺癌的临床效果及毒副反应。
    方法:42例转移性乳腺癌患者中,23例为既往使用蒽环类治疗失败,给予希罗达联合诺维本治疗(诺维本25 mg/m2,化疗周期的第1天及第8天各静脉滴注1次;希罗达2 000 mg/m2,口服,2次/d,服用2周,每3周为1个周期);19例既往未曾采用蒽环类治疗,给予希罗达联合吡柔比星(吡柔比星35 mg/m2,化疗周期的第1天及第8天各静脉滴注1次;口服希罗达,剂量、用法疗程同上)。所有患者至少接受化疗6周期后方可评价疗效。
    结果:希罗达联合诺维本组完全缓解(CR)5例,部分缓解(PR)12例,稳定(SD)4例,进展(PD)2例;有效率为 73.91%(17/23);中位疾病进展时间(TTP)为8.4个月,中位生存期(MST)为18.1个月。希罗达联合吡柔比星组CR 5例,PR 7例,SD 2例,PD 5例;有效率为 63.16%(12/19);TTP为个7.8个月,MST为17.5个月。两组之间化疗有效率无明显差异(P>0.05)。两组主要毒副反应为白细胞减少,其中III~IV度占52.4%;手足综合征II~III级者占19.0%。
    结论:卡培他滨为主的联合化疗方案治疗转移性乳腺癌效果确切,毒性反应可耐受。

    Abstract:

    Objective: To investigate the efficacy and toxicity of capecitabine (Xeloda) -based combination chemotherapy for metastatic breast cancer (MBC).
    Methods: Of the 42 MBC patients, 23 cases who had failed previous anthracycline-based chemotherapy received a regimen of Xeloda plus navelbine (treatment schedule: navelbine 25 mg/m2 iv. on day 1 and day 8, Xeloda 2000 mg/m2 po. twice daily from day 1 to day 14 every 3 weeks); the other 19 cases who had no prior anthracycline-based chemotherapy received Xeloda plus pirarubicin (treatment schedule: pirarubicin 35 mg/m2 iv. on day 1 and day 8, Xeloda with the same dosage regimen and treatment course as above-mentioned). The efficacy was assessed after at least 6 cycles of chemotherapy in all patients.
    Results: Of the patients who received Xeloda plus navelbine, complete response (CR) was achieved in 5 cases, partial response (PR) in 12 cases and stable disease (SD) in 4 patients, and progressive disease (PD) was observed in 2 patients; the response rate was 73.91% (17/23); the median time to progression (TTP) was 8.4 months, and median survival time (MST) was 18.1 months. Of the patients who received Xeloda plus pirarubicin, the cases of CR, PR, SD and PD were 5, 7, 2 and 5, respectively; the response rate was 63.16% (12/19); TTP and MST was 7.8 and 17.5 months, respectively. The effective rate between the two sets of schedules showed no significant difference (P>0.05). The major toxicity and adverse events for all the patients were leukopenia (Grade III-IV in 52.4% patients) and hand-foot syndrome (Grade II-III in 19.0% patients).
    Conclusions: Capecitabine-based combination chemotherapy has substantial efficacy for MBC with tolerable toxicity profiles.

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恽蓓|孙国荣.卡培他滨为主的联合方案治疗晚期转移性乳腺癌[J].中国普通外科杂志,2011,20(11):1179-1183.
DOI:10.7659/j. issn.1005-6947.2011.11.008

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  • 收稿日期:2010-12-10
  • 最后修改日期:2011-07-05
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  • 在线发布日期: 2011-11-15