医学毕业论文--NP 与CAF 方案治疗晚期乳腺癌疗效及副反应分析.docVIP

NP 和CAF 方案治疗晚期乳腺癌疗效及副反应分析 作者：陈绍水 宁方玲 郭毅 吕俊华 【关键词】 NP 【摘要】目的比较NP和CAP方案对晚期乳腺癌的疗效和毒副反应。方法78 例晚期乳腺癌患者分别接受NP、CAF方案的治疗，病例数分别为37 和41，观察疗效和毒副反应。结果NP 组总有效率为 64.9%（其中初治组 73.7%，复治组 55.6%），CAF组有效率为 41.5%（其中初治组 52.4%，复治组30.0%）。两组初治、复治病例有效率差异无统计学意义（P＞0.05），总有效率差异有统计学意义（P＜0.05）；其中位缓解期分别为7.6和8.1个月，中位生存期分别为17.5和18.6个月，两组差异无统计学意义。NP组静脉炎发生率多于CAF 组，而CAF组心脏毒性及脱发多于NP组，其余不良反应发生率相近。结论NP 方案是治疗晚期乳腺癌的有效方案，其不良反应均能耐受。 【关键词】乳腺癌；化学疗法；长春瑞滨；阿霉素 【Abstract】ObjectiveTo compare the effect and the toxicity of NP(navelbine+cisplatin)and AFcyclophosphamide+adriamycin+5- fluorouracil)regimen in the treatment for patients with advanced breast ancer.MethodsSeventy- eight cases with advanced breast cancer were studied respectively 37 and 41 patients which were treated with NP and CAF regimen,respectively.ResultsIn NP group the response of rates (RR)of initial treatment cases,the retreatment cases,and the whole cases were 73.7%,55.6% and 64.9%,respectively.whereas in CAF group,the RR of initial treatment cases,the retreatment cases and the whole cases were 52.4%,30.0%,and 41.5%,respectively.The median time to progression(TTP) and the median survival were 7.6 months and 17.5 months in NP group,respectively.The median TTP was 8.1 months and the median survival was 18.6 months in CAF group.There were sigmificant differences between two groups in the RR of the whole cases (P＜0.05).However,there was no significant difference in the RR of the initial treatmemt cases and the retreatment cases,the median TTP and the median survival(P＞0.05).Phlebitis was more serious in NP group than in CAF group(P＜0.05);However,the toxicity of heart and alopecie was more serious in CAF group than in NP group(P＜0.05).There was no significant difference in the other side effects between the two groups.ConclusionNP regimen is effective for the treatment of advancedbreast cancer patients and all side effects were tolerable. 【Key words】breast cancer,chemotherapy,vinorelbine,adriamycin 乳腺癌是女性最常见的恶性肿瘤之一，发病率呈逐年上升趋势。联合化疗在提高乳腺癌生存率方