摘要
目的评价奥沙利铂联合替吉奥治疗难治性晚期乳腺癌的疗效和不良反应。方法选择72例经病理证实已经接受分别以紫杉类、蒽环类为主的化疗方案治疗失败的晚期乳腺癌患者，予多周期奥沙利铂联合替吉奥方案化疗：第1天予奥沙利铂，135mg／m2，加入5％葡萄糖注射液500ml中，静脉滴注不少于2h完成；每天早、晚饭后口服替吉奥胶囊共40～60mg，连服14d，停用7d，两药均21d重复；每2周期评价疗效，有效及稳定患者继续化疗，最长不超过6周期。结果乳腺癌患者完全缓解2例（2．8％），部分缓解26例（36．1％），客观有效率为38．9％，疾病控制率为69．4％。患者中位无进展生存期为7．7个月，中位总生存期为12．3个月。亚组分析显示，Ⅳ期、2个及以上部位转移、既往使用紫杉类、蒽环类化疗后仍然进展的患者中位总生存期分别明显短于ⅢC期、1个部位转移、既往化疗有效及稳定的患者，差异有统计学意义（10．5个月：15．0个月,X2=4．469，P=0．035；9．3个月：15．0个月，X2=8．297，P=0．004；10．0个月：14．0个月,X2=4．077，P=0．043）。Ⅲ-Ⅳ级不良反应包括中性粒细胞减少（19．4％）、恶心呕吐（8．3％）和外周神经毒性（2．8％）；腹泻、肝功能损害、口腔炎、贫血和手足综合征等多为I-Ⅱ级。结论奥沙利铂联合替吉奥治疗难治性晚期乳腺癌安全、有效，并且不良反应可以耐受。
Objective To evaluate the efficacy and toxicity of the combination of oxaliplatin and S-1 in the treatment of patients with advanced breast cancer. Methods A total of 72 patients with advanced breast cancer after the treatment failuer of anthracycline and taxane were treated with oxaliplatin and S-1. The first day, they were given oxaliplatin, 135 mg/m2, with the 5% glucose injection 500 ml, the time of intravenous drip should be more than 2 hours. And the S-1 was taken after breakfast and dinner, the dose was 40-60 mg, and the time of duration was 2 weeks, then they had 7 days to rest. The cycle was 21 days. Every 2 cycles, we estimated the efficacy. Patients who were effective and stable kept that chemotherapy regimens, the maximum duration was 6 cycles. The efficacy and toxieities were evaluated after cycles of chemotherapy. Results Two cases （2.8%） had complete response （CR）, 26 cases （36.1%） had partial response （PR）. The response rate （RR） was 38.9% and the disease control rate （DCR） was 69.4%. The median progress free survival （PFS） was 7.7 months and the median overall survival （OS） was 12.3 months. Subgroup analysis showed that the OS of patients who belong to stage IV, had two or more metastases or with failure treatment after being trea- ted with anthracycline and taxane was notably shorter than the patients who belong to stage Ⅲ C, only one metastasis, with effective treatment after being treated with anthracycline and taxane, and the differences were statistically significant （ 10.5 months vs. 15.0 months, X2 =4. 469, P =0. 035 ; 9.3 months vs. 15.0 months, X2 = 8. 297, P = 0. 004 ; 10.0 months vs. 14.0 months, X2 = 4. 077, P = 0.043 ）. The main side effects were neutropenia （19.4%）, nausea （8.3%） and nerve toxicity （2.8%）, mainly 3-4 degree, and could be well-tolerated. The others were diarrhea, impaired liver function, stomatitis, anemia and hand-foot syndrome, main- ly I-2 degree. Conclusion Oxaliplatin combined with S-1 is effective and tolerable in treatment of patients with advanced breast cancer, the adverse reactions can be tolerated.
出处
《国际肿瘤学杂志》
CAS
2016年第5期330-334,共5页
Journal of International Oncology
关键词
乳腺肿瘤
肿瘤转移
药物疗法
Breast neoplasms
Neoplasms metastasis
Drug therapy
