吉西他滨不同给药方式联合顺铂治疗晚期乳腺癌的临床疗效及安全性

摘要

目的:观察吉西他滨不同给药方式联合顺铂治疗蒽环类或紫杉醇类耐药乳腺癌的临床疗效及安全性.方法:选取2014年8月至2017年9月期间入住我院及安徽省立医院的晚期乳腺癌病人,既往接受含蒽环类或紫杉醇类药物的化疗方案,共60例,根据化疗方案的不同,分为对照组(30例)和观察组(30例).对照组:吉西他滨1 000 mg/m2d1、8,顺铂25 mg/m2d1～3;观察组:吉西他滨 1 000 mg/m2d1、5,顺铂25 mg/m2 d1～3.结果:对照组客观有效率为33.33％,疾病控制率为73.33％,观察组客观有效率为40.00％,疾病控制率为80.00％,差异无统计学意义(P＞0.05).两组的主要不良反应均为白细胞减少、中性粒细胞减低、血小板减少、胃肠道反应及肝功能异常,Ⅲ－Ⅳ级不良反应发生率差异无统计学意义(P＞0.05).结论:应用吉西他滨联合顺铂治疗蒽环类或紫杉醇类耐药晚期乳腺癌患者时,缩短吉西他滨给药间期,可获得与对照组相当的疗效,同时不增加不良反应,缩短了住院时间,减少了住院费用,可在临床进一步研究应用.%Objective:To observe the efficacy and safety of different dosages of gemcitabine combined with cispla-tin in patients with advanced breast cancer.Methods:A total of 60 cases metastatic breast cancer patients with drug resistance of anthracyclines or taxane treated from August 2014 to September 2017 in our hospital and Anhui Provin-cial Hospital were selected.They were divided into control group(30 cases)and observation group(30 cases)ac-cording to the different chemotherapy regimens.In control group,they were treated with gemcitabine 1 000 mg/m2d1,8 and cisplatin 25 mg/m2d1～3.In observation group,they were treated with gemcitabine 1 000 mg/m2d1,5and cisplatin 25 mg/m2d1～3.Results:In control group,the overall response rate was 33.33％,and the disease control rate was 73.33％.In observation group,the overall response rate was 40.00％,and the disease control rate was 80.00％.There was no statistically significant difference(P＞0.05).The main side effects of two groups included leukopenia,neutropenia,thrombocytopenia,gastrointestinal reactions and hepatic dysfunction.And there was no significant differ-ence in the incidence of side effects between gradeⅢandⅣ(P＞0.05).Conclusion:When gemcitabine combined with cisplatin treated advanced breast cancer patients with drug resistance of anthracyclines or taxane,they can shorten the dosage of gemcitabine administration,and obtain the same curative effect,and can not add adverse reactions.It can be further used in clinical research and application.