目的 观察白蛋白结合型紫杉醇在既往紫杉类(紫杉醇、多西紫杉醇)耐药的晚期乳腺癌治疗中的近期疗效和安全性.方法 选取22例既往曾使用紫杉类药物治疗失败的晚期乳腺癌患者予含白蛋白结合型紫杉醇方案治疗.白蛋白结合型紫杉醇每周期剂量范围为260 mg·m-2,静脉滴注30 min,第1、8天给药(用药前不予抗过敏预处理),合并抗肿瘤药按常规方法给药,21 d为一周期,每2个周期评估疗效及毒副作用.结果 22例患者共完成106个周期,中位周期数为4个周期(2～6个周期).获完全缓解(CR)0例(0.0％),部分缓解(PR)7例(31.8％),稳定(SD) 13例(59.1％),进展(PD)2例(9.1％),总有效率(ORR=CR+ PR)为31.8％,临床获益率(CBR=CR+PR+ SD)为90.9％,中位无疾病进展时间(PFS)为5.9个月.主要毒副作用为骨髓抑制、四肢麻木、肌肉关节酸痛、脱发及消化道反应；严重毒副作用主要为骨髓抑制,无化疗相关死亡病例.结论 白蛋白结合型紫杉醇治疗既往紫杉类耐药的晚期乳腺癌仍显示出较好的疗效,毒副作用小,耐受性好.%Objective To observe the efficacy and safety of albumin-bound paclitaxel in patients with taxanes (paclitaxel and docetaxel)-resistant advanced breast cancer.Methods Twenty-two patients with taxanes-resistant advanced breast cancer were intravenously infused with albuminbound paclitaxel 260 mg · m-2 for 30 minutes on day 1 and 8.Antitumor drugs were administered conventionally.Antiallergic pretreatment was not performed before albumin-bound paclitaxel infusion.The efficacy and toxicities were assessed every 2 cycles.Results A total of 106 cycles of treatment were performed in the 22 patients.The median number of cycles was 4 per patient (range,2 to 6 cycles).Among the 22 patients,7 (31.8％) had partial remission,13 (59.1％) had stable disease and 2 (9.1％) had progressive disease.No patients had complete remission.The overall response rate was 31.8％ and clinical benefit rate was 90.9％.The median progression-free survival was 5.9 months.The common toxicities included myelosuppression,limb numbness,myalgia,alopecia and gastrointestinal reactions.The most serious toxicity was myelosuppression.No chemotherapy-related deaths occurred in all patients.Conclusion Albumin-bound paclitaxel has good efficacy,low toxicity and high tolerance in the treatment of taxanes-resistant advanced breast cancer.
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