含铂与不含铂方案治疗三阴性乳腺癌首发肺转移的疗效比较

摘要

Objective To compare the effect of first-line treatment with platinum-based chemotherapy and non-platinum-based chemotherapy in patients with lung metastases from triple negative breast cancer (TNBC).Methods Sixty-five eligible patients were divided into platinum-treated group and non-platinum-treated group according to the first-line therapy.Factors predicting the chemotherapeutic efficacy included overall survival (OS),progression-free survival (PFS) and objective response (OR).Results In the platinum-treated group of 32 patients,2 cases (6.3％) achieved CR,16 cases (50.0％) achieved PR,11 (34.4％) cases achieved SD,and 3 patients (9.4％) achieved PD.In the non-platinumtreated group of 33 patients,2 cases (6.1％) achieved CR,6 cases (18.2％) achieved PR,16 cases (48.5％) achieved SD,and 9 cases (27.3％) achieved PD.Median PFS was significantly longer in the platinunm-treated group than in the non-platinum-treated group (10 months vs.6.0 months,P =0.012),and OS was also improved (32 months vs.22 months,P =0.006).Multivariate analysis of several factors including local-regional lymph node involvement,lung metastasis-related symptoms,first-line platinumbased chemotherapy,disease-free interval,size and number of lung lesions,showed that first-line platinumbased chemotherapy was an independent prognostic factor for TNBC patients with lung metastases.Conclusions Compared with non-platinum-based chemotherapy,the first-line platinum-based chemotherapy can improve PFS and OS in TNBC patients with metastases confined to the lungs.%目的 比较含铂与不含铂方案治疗三阴性乳腺癌首发肺转移的疗效.方法 符合入选标准的65例患者按照一线化疗方案是否含铂类药物(顺铂或卡铂),将其分为含铂组与不含铂组.疗效观察指标包括无进展生存时间(PFS)、总生存时间(OS)和客观缓解率.结果 32例含铂组患者中,完全缓解(CR)2例(6.3％),部分缓解(PR) 16例(50.0％),疾病稳定(SD)11例(34.4％),疾病进展(PD)3例(9.4％).33例不含铂组患者中,CR 2例(6.1％),PR 6例(18.2％),SD 16例(48.5％),PD 9例(27.3％).含铂组和不含铂组患者的中位PFS分别为10和6个月,差异有统计学意义(P=0.012);含铂组和不含铂组患者的中位OS分别为32和22个月,差异有统计学意义(P =0.006).Cox多因素分析结果显示,仅一线含铂方案化疗与患者的预后有关(P＜0.05),为三阴性乳腺癌首发肺转移的独立预后因素.结论 与不含铂化疗方案相比,含铂方案可延长三阴性乳腺癌首发肺转移患者的PFS和OS.