54例蒽环及紫杉类耐药转移性乳腺癌患者治疗的回顾性分析

摘要

Objective To retrospectively analyze the Docetaxel and Anthracycline treatment for patients with recurrent metastatic breast cancer (RMBC) and compare the clinical effect and safety in an attempt to provide new thoughts and methods for advanced RMBC.Methods Of the 54 patients with RMBC resisted of Docetaxel and Anthracycline,22 (PV group) were treated with intravenous injection of navelbine combined with pemetrexed,oral administration of low dose of folate and vitamin12 as well as hexadecadrol in advance while other 32 (CV group) with intravenous injection of navelbine combined with cisplatin.The clinical effect and adverse reactions in both groups were evaluated.Results In PV group,there were 1 complete remission(CR),11 partial remission (PR),8 stable disease (SD) and 2 progressive disease (PD) with effective rate being 54.5％ while in CV group there were 2 CR,14 PR,12 SD and 4 PD with effective rate being 50.0％,indicating there had no difference in two groups.The adverse reactions mainly includes bone marrow suppression and gastrointestinal reaction,etc.Conclusion Navelbine combined with pemetrexed and navelbine combined with cisplatin are effective with tolerable toxic and adverse reactions,being potential chemotherapies in treating patients with RMBC.%目的 回顾性分析治疗蒽环及紫杉类耐药转移性乳腺癌(RMBC)的2种方法,对临床疗效和安全性进行比较,以期为晚期转移性乳腺癌的治疗提供新的思路和方法.方法 蒽环及紫杉类耐药转移性乳腺癌患者54例,长春瑞滨联合培美曲塞治疗22例(PV组),静脉滴注培美曲塞,同时服用低剂量叶酸及维生素B12支持,预服地塞米松；静脉滴注长春瑞滨.长春瑞滨联合顺铂治疗32例(CV组),静脉滴注顺铂、长春瑞滨.评价2组的临床疗效及不良反应发生情况.结果 PV组的22例中,完全缓解(CR)1例,部分缓解(PR)11例,疾病稳定(SD)8例,进展(PD)2例,有效率为54.5％；CV组的32例中,CR 2例,PR 14例,SD 12例,PD 4例,有效率为50.0％.2组疗效比较差异无显著性,不良反应主要为骨髓抑制、胃肠道反应等.结论长春瑞滨联合培美曲塞治疗RMBC与长春瑞滨联合顺铂联合化疗相比疗效确切,毒副作用可耐受,可考虑作为治疗耐受转移性乳腺癌的新化疗方案.