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TCH方案治疗老年HER-2阳性乳腺癌安全性分析

         

摘要

Objective:To investigate chemotherapy-induced toxicity and Herceptin-associated cardiac adverse effect of TCH regimen( docetaxel cycolohosphate plus Herceptin )in elderly patients with HER -2 positive breast cancer. Methods:All 24 elderly HER-2 positive breast cancer patients,including 5 patients with neoadjuvant chem-otherapy and 19 patients with adjuvant chemotherapy,were treated at most 6 cycles with TCH regimen[ docetaxel 75 mg/m2 ,d1 ,plus carboplatin AUC=6,d1 ,plus Herceptin 6mg/kg( first dose 8mg/kg)every 21 days]. Toxicity was graded according to the National Cancer Institute Common Toxicity Criteria(NCI-CTC),version 3. 0. The Herceptin was continued until one year every 3 weeks with 6mg/kg after chemotherapy. Assessment of LVEF by echocardio-graphy was performed at baseline,3,6,9,12,18 months. Results:A total of 142 cycles of TCH regimen were delivered with median number of 6 cycles. GradeⅢ/Ⅳleukopienia was 37. 5%,neutropenia febrile 8. 33%,peripheral neuro-toxicity 29. 41%,no chemotherapy-related death. LVEF declined during Herceptin treatment. The nadir of LVEF oc-curred at 12 months and returned approximately to baseline level at 18 months. At median 27 months follow up,no pa-tient suffered congestive heart failure. Conclusion:The hematotoxicity and nonhematotoxicity of TCH regimen were well tolerated,and cardiac dysfunction was uncommon. TCH regimen was one of good choice for elderly patients with HER-2 positive breast cancer.%目的:观察TCH方案(多西紫杉醇﹢卡铂﹢赫赛汀)治疗老年人表皮生长因子受体-2( human epi-dermal growth factor receptor-2,HER-2)阳性乳腺癌的近期化疗毒性及远期心脏毒性。方法:24例老年HER

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