GP和GEM+NDP方案治疗复发转移性乳腺癌的临床疗效分析

摘要

Objective To analyze the clinical efficacy and toxicities of gemcitabine combined with cisplatin and gemcitabine combined with Nedaplatin (NDP) on recurrent and metastatic breast cancer (MBC). Methods Fifty-two MBC patients were di-vided into gemcitabline combined with cisplatin (GP) Group (n=29) and gemcitabline combined with nedaplatin (GEM+NDP) Group (n=23) by using the principle of random assigning. The two treatments took 21 days as a cycle. The clinical efficacy and the toxicities were evaluated after two cycles and four cycles. Results After two cycles, the overall response rate (ORR) was 48.28%and 60.87%respectively in GP Group and GEM+NDP Group, and there was no significant difference between them (P>0.05). Except the PD patients, the others continued to get chemotherapy. After four cycles, the ORR was 31.58%and 50.00%respectively in GP Group and GEM+NDP Group, and there was still no significant difference between them (P>0.05). There were no significant differences between the two groups in the incidence of third degree leucopenia, Third degree throm-bocytopenia and anemia. The incidence of gastrointestinal reaction in GEM+NDP Group (13.0%) was obviously lower than that of GP Group (69.0%), with significant difference (P<0.05). There was one case (3.4%)of First degree impaired renal function and five cases (17.2%) of Second degree impaired renal function in GP Group, while in GEM+NDP Group there was only one case (4.3%) of First degree impaired renal function. There were significant differences between them (P<0.05). Conclusion GP regimen and GEM+NDP regimen had similar efficacy in the treatment of anthracycline or taxane-resistant recurrent and meta-static breast cancer, and the toxicities can be tolerated.%目的：探讨吉西他滨联合顺铂（GP方案）和吉西他滨联合奈达铂（GEM+NDP方案）治疗复发转移性乳腺癌的临床疗效及不良反应。方法按照随机原则，将52例复发转移性乳腺癌患者分为GP组（29例）和GEM+NDP组（23例），两种方案均以21天为1个治疗周期，治疗2周期和4周期后比较其临床疗效及不良反应。结果治疗2周期后， GP组和GEM+NDP组的治疗总有效率分别为48.28％和60.87％，差异无统计学意义（P>0.05）。除PD以外的患者继续化疗，化疗4周期后，GP组及GEM+NDP组的总有效率分别为31.58％和50.00％，差异无统计学意义（P>0.05）。GP组及GEM+NDP组III级白细胞下降、III级血小板减少、贫血的发生率比较，差异均无统计学意义（P>0.05）；GEM+NDP组胃肠道反应的发生率（13.0％）明显低于GP组（69.0％）（P<0.05）。GP组1例发生I度肾功损害（3.4％），5例发生II度肾功损害（17.2％）；而GEM+NDP组仅1例I度肾功损害（4.3％），差异有统计学意义（P<0.05）。结论 GP方案和GEM+NDP方案治疗蒽环类和（或）紫杉类耐药的复发转移性晚期乳腺癌的疗效相当，不良反应可以耐受。