长春瑞滨联合顺铂治疗中晚期乳腺癌临床观察.docVIP

长春瑞滨联合顺铂治疗中晚期乳腺癌临床观察【摘要】 目的 观察长春瑞滨（盖诺）联合顺铂方案治疗中晚期乳腺癌的临床疗效。方法 运用盖诺（25 mg/m2IVD 第1、8天）加顺铂（DDP 80 mg/m2IV 第1天）治疗中晚期乳腺癌36例。结果 总有效率达66．7%。主要不良反应为骨髓抑制、胃肠道反应和静脉炎。白细胞减少的发生率100%，其中Ⅲ~Ⅳ度达55．6%。恶心、呕吐的发生率92．3%，Ⅲ~Ⅳ度达11．1%。静脉炎的发生率11．1%。结论 国产长春瑞滨联合顺铂对中晚期乳腺癌疗效确切，且毒性可以耐受，可以作为对蒽环类药物治疗后复发，中晚期乳腺癌患者的第二线治疗方案。 【关键词】 长春瑞滨（盖诺）；顺铂；联合化疗；中晚期乳腺癌 Combination Chemotherapy With Vinorelbine and Cispatin in the Treatment of Advanced Breast Cancer ZHANG Jin-yu.The Central Hospital of QianjiangCity,Qianjiang 433100,China 【Abstract】 Objective To evaluate the effective of combination chemotheraphy of NVB plus cisplatin on advanced breast cancer.Methods 26 patients of advanced breast cancer were treated with NVB 25 mg/m2 IVD for day1 and day8 and cisplatin 80 mg/m2 IV for day1.Results Complete response was observed in 3 patients,partial response in 12 patients,with an overall response rate of 57．6%.The most common toxicities were myelosuppression,vomiting and phlebitis.Leukopenia was observed in all patients (100%) and grade 3 and grade 4 leukopenia in most of patients(57．7%).The rates of vomiting were 92．3%,and grade 3 and grade 4 vomiting were 11．5%.The rates of phlebitis were 15．4%.Conclusion The NP combination chemotheraphy was effective for advanced breast cancer and the toxicities were tolerable.It serves as the second line chemotherapy regimen on patient with anthracycline-resistant metastatic breast cancer. 【Key words】 Vinorelabine;Cisplatin;Combination chemotherapy;Advanced breast cancer 化疗是治疗中晚期乳腺癌的一种重要手段，长春瑞滨（商品名盖诺）作为一种新一代半合成的长春碱类抗癌药，具有广谱抗癌作用。为观察长春瑞滨（盖诺）和顺铂（NP）方案治疗转移性乳腺癌的疗效，我们采用该方法治疗中晚期乳腺癌36例，观察了近期疗效和耐受性，现报告如下。 1 材料与方法 1．1 临床资料 36例均为女性，年龄38~60岁、中位年龄49岁，KPS评为≥70分， 本组原发灶均经乳腺癌改良根治术或根治术，并经病理证实，且既往均行多程含蒽环类方案的化疗。转移灶经X-射线、CT、骨扫描等确诊。其中1个淋巴结区或器官转移者26例，转移2个者8例，转移3个以上者2例。 1．2 治疗方法 盖诺25 mg/m2加入生理盐水80 ml，快速滴入或冲入，第1天和第8天。顺铂80 mg/m静脉推注，第1天（配合水化），21 d为1个周期，共用2~3个周期。盖诺静脉滴注前后给予地塞米松5 mg，iv，静注完盖诺后用生理盐水250 ml快冲管。 1．3 评价标准 第2~3个周期后行影像学复查及肿瘤病灶的测量疗效按WHO（1981年）标准分为完全缓解（CR）、部分缓解（PR）、稳定（SD）和