吉西他滨联合顺铂治疗晚期三阴乳腺癌临床观察.docVIP

吉西他滨联合顺铂治疗晚期三阴乳腺癌临床观察 　　【摘要】目的观察吉西他滨联合顺铂(GP方案)治疗蒽环类和紫杉类失败的晚期三阴乳腺癌近期疗效和毒副反应。方法30例晚期三阴乳腺癌患者给予吉西他滨1.0 g/m2静脉滴注第1、8天(30min内滴注完毕), 顺铂75 mg/m2, 分2 d静脉滴注(第1、2天), 21 d为1周期, 2周期后评价客观疗效。30例患者近期疗效 CR: 0例, PR: 11例(36.7% ) , SD : 12例(40% ) , PD :7 例(23.3%) ; 总有效率36.7%。该方案的主要毒副反应为胃肠道反应和骨髓抑制。结果 疗效 30例患者均完成2周期化疗, 均可评价疗效, 其中CR 0例, PR 11例(36.7%), SD例12( 40 % ), PD7 例(23.3% ), 有效率为36.7%。不良反应 主要表现为消化道反应、骨髓抑制, 无治疗相关性死亡。结论GP方案治疗晚期三阴乳腺癌具有良好的近期疗效, 耐受性较好。 　　【关键词】晚期三阴乳腺癌; 吉西他滨; 顺铂 　　 　　Clinical study of gemcitabine plus cisplatin in the treatment of advanced triple negative breast cancer LI Hui-li, CAO Lei, WANG Jing. Third Affiliated Hospital of Inner Mongolia Medical College Baogang Hospital, Baotou 014010, China 　　【Abstract】Objective To observe the efficacy and toxicity of gemcitabine(GEM) plus cisplatin(DDP) in the treatment of advanced TNBC after the failure of anthracyclines and taxanes. Methods There were 30 cases of advanced triple negative breast cancer(TNBC) with anthracyclines and taxanes resistance who were treated with GEM 1.0 g/m2, for 1st and 8th day and DDP 75mg/m2 intravenous drip in 2 days (1st and 2nd day)21days repeatedly. After 2cycles, the response and side effects were evaluated. All cases were followed up for more than 6 months. Results Efficacy of the 30 cases were as follows: PR 11 cases (36.7%), SD 12 cases(40%), PD 7 cases(23.3%), with a total rate of 36.7%. Myelosupression and gastrointestinal tract reaction were the most common toxicities. Conclusion The combination of gemcitabine and cisplatin is effective and safe in treatment of advanced TNBC. 　　【Key words】Advanced triple negative breast cancer; Gemcitabine; Cisplatin 　　三阴乳腺癌(triple negative breast cancer, TNBC)是指ER、PR、HER-2 均为阴性的乳腺癌, 约占乳腺癌的15%左右。其具有发病年龄早、大肿块、高侵袭性、恶性程度高、淋巴结转移率高、易复发转移、生存率低等特点［1］。因内分泌治疗和曲妥珠单抗治疗无效, 故化疗成为主要治疗手段。作者观察了2007年1月~2012年3月30例蒽环类和紫杉类治疗失败的晚期三阴乳腺癌患者使用GP方案(吉西他滨GEM 联合顺铂DDP)化疗的近期疗效和不良反应, 现报告如下。 　　1资料与方法 　　1. 1一般资料2007年1月~2012年3月30例在本院治疗的患者, 均为女性。符合以下标准：①病理确诊的晚期乳腺癌, ER、PR 和HER-2均为阴性; ②至少有一个符合R