替吉奥联合放疗治疗40例局部复发三阴乳腺癌的临床观察

摘要

目的：观察替吉奥联合三维适形放疗(3-DCRT)治疗局部复发三阴乳腺癌患者的近期疗效及治疗的安全性。方法40例经病理证实的局部复发的三阴乳腺癌患者接受了三维适形放疗（3￣DCRT），CTV DT50Gy/25F，GTV DT56～60Gy/28～30F，同期接受替吉奥口服化疗，(40～60)mg/(m2·d)，2次/d，连服4w，休息2w，共2周期。结果疗效评价CR 7例(17.5%)，PR 24例(60.0%)，SD 8例(20.0%)，PD 1例(2.5%)，总有效率(CR+PR)77.5%；本组主要毒副反应为主要毒副反应为中性粒细胞减少、胃肠道反应、皮肤反应、口腔粘膜炎、周围神经毒性，以I～Ⅱ度为主，Ⅲ～Ⅳ度少见，其中中性粒细胞减少发生率为67.5%，恶心呕吐发生率为52.5%，皮肤反应发生率为50.0%，口腔粘膜炎发生率为42.5%，周围神经毒性发生率为20.0%。肝肾功能损害、腹泻、便秘等发生率很低。结论替吉奥联合三维适形放疗(3￣DCRT)方案的同期放化疗方案是局部复发三阴乳腺癌较好的治疗方法，其近期疗效确切、治疗的依从性高、毒副反应可耐受，值得临床应用。%Objective To observe the efficacy of Gio combined with three￣dimensional conformal radiotherapy in the treatment of local recurrence TNBC and safety of the treatment. Methods Forty patients with local recurrence TNBC confirmed by pathologically were received 3￣DCRT, CTV DT50Gy/25F,GTV DT56~60Gy/28~30F combination with Gio oral chemotherapy, (40~60)mg/(m2?d), 2 times/d, and serving four weeks, rest two weeks, a total of 2 cycles.Results The over-all efficiency rate was 77.5%,with CR 7 cases(17.5%),PR 24 cases (60.0%),SD 8 cases (20.0%), PD 1 case (2.5%).The group of major toxicities were neutropenia, gastrointestinal tract, skin reac-tions, oral mucositis, peripheral neurotoxicity, I~Ⅱ degree were in mainly,Ⅲ~Ⅳ degree were rare. The whole group of neutropenia occurred at a rate of 67.5%, nausea and vomiting occurred at a rate of 52.5%, skin react incidence was 50.0% and peripheral neurotoxicity occurred at a rate of 20.0%.The incidence of liver and kidney dysfunction, diarrhea, constipation, etc is very low. Conclusion Combination of Gio with three Dimensional-conformal radiotherapy concurrent ra-diochemotherapy was a good method in local recurrence TNBC. Its recent effects was curative and toxicity can be tolerated. It was worthy of clinical application.