顺铂联合长春瑞滨或吉西他滨对复发转移性乳腺癌的疗效和不良反应对照研究.docVIP

顺铂联合长春瑞滨或吉西他滨对复发转移性乳腺癌的疗效和不良反应对照研究 　　摘要：目的 比较顺铂联合长春瑞滨或吉西他滨治疗转移性乳腺癌的疗效和安全性。方法 选取四川省巴中市中心医院2010年1月～2013年6月转移性乳腺癌75例，随机分为NP组（长春瑞滨+顺铂）和GP组（吉西他滨+顺铂），两组均给予顺铂75 mg/m2，静脉滴注，分3 d用；NP组给予长春瑞滨25 mg/m2，第1、8 d；GP组给予吉西他滨1000 mg/m2，第1、8 d。21 d为1个周期，共化疗6个周期。结果 NP组38例，总缓解率47.36%（18/38），GP组37例的总缓解率为40.54%（15/37），两组总缓解率间的差异无统计学意义（P0.05）；NP组Ⅲ/Ⅳ度血小板减少发生率5.40%（2/38），皮疹发生率2.63（1/38）；明显低于GP组24.32%（9/37），21.6%（8/37），差异有统计学意义（P0.05）。结论 长春瑞滨或吉西他滨联合顺铂治疗复发转移性乳腺癌疗效相似，但前者毒副作用稍低于后者，可作为晚期复发性乳腺癌的二线治疗或解救方案。 　　关键词：顺铂；长春瑞滨；吉西他滨；复发转移性乳腺癌；不良反应 　　Abstract：Objective To compare the efficacy and safety of cisplatin plus vinorelbine or gemcitabine in treatment of recurrent metastatic breast cancer.Methods During January 2010 and June 2013，75 patients with breast cancer，who received second-line internal medicine of rescue therapy，were included in this study.The patients were randomly divided into NP group（vinorelbine and cisplatin）and GP group（gemcitabine and cisplatin）.Results Thirty-eight patients were randomly chosen to receive NP，the ORR（objective response rate）was 47.36%（18/38）；and the ORR of GP group was 40.54%（15/37），there was no statistically significant difference（P0.05）；the rate of III/IV grade thrombocytopenia in NP group was 5.40%（2/38），the incidence of rash was 2.63（1/38）；the incidences of thrombocytopenia and rash were significantly lower than that in GP group，which were 24.32%（9/37）and 24.32%（8/37），P0.05.The differences of the incidences of digestive reaction，anemia，granulocytopenia，liver function damage and hair loss between the two groups were not statistically significant.Conclusion NP and GP regimen achieved similar efficacy in the treatment of recurrent metastatic breast cancer.However，NP regimen，less adverse events noted，should be recommended as a second-line therapy for breast cancer patients. 　　Key words：Cisplatin；Vinorelbine；Gemcitabine；Recurrent metastatic breast cancer；Adverse events 　　根据世界卫生组织（WHO）统计资料，乳腺癌是威胁女性健康的常见肿瘤。近年来我国乳腺癌发病率呈上升趋势，蒽环类和紫杉类是应用最为广泛的化疗药物，但临床上乳腺癌患者对这两类药物产生耐药性的