NX方案和GP方案治疗蒽环类及紫杉类药物治疗后复发转移乳腺癌的临床疗效分析

中国临床药理学与治疗学 ›› 2013, Vol. 18 ›› Issue (8): 918-923.

NX方案和GP方案治疗蒽环类及紫杉类药物治疗后复发转移乳腺癌的临床疗效分析

朱益平, 盛莉莉, 王路, 吉兆宁

皖南医学院弋矶山医院肿瘤内科,芜湖 241001,安徽

收稿日期:2013-02-18 修回日期:2013-06-06 出版日期:2013-08-26 发布日期:2013-07-31
通讯作者: 吉兆宁,男,博士,主任医师,教授,研究方向:恶性肿瘤个体化综合治疗。Tel: 13855366810 E-mail: jzning @163.com
作者简介:朱益平,男,本科,主治医师,研究方向:实体瘤的化疗和综合治疗。Tel: 13965197031 E-mail: aulft@126.com

Analysis on clinical efficacy of vinorelbine combined with capecitabine (NX) and gemcitabine combined with cisplatin(GP) for recurrent metastatic breast cancer after anthracycline- and taxane- treatment

ZHU Yi-ping, SHENG Li-li, WANG Lu, JI Zhao-ning

Department of Oncology,Yijishan Hospital, Wannan Medical College,Wuhu 241001,Anhui, China

Received:2013-02-18 Revised:2013-06-06 Online:2013-08-26 Published:2013-07-31

摘要/Abstract

摘要： 目的: 观察长春瑞滨联合卡培他滨(NX)以及吉西他滨联合顺铂(GP)两种方案用于蒽环类和紫杉类药物治疗后复发转移性乳腺癌的有效性和安全性。方法: 41例蒽环类和紫杉类药物治疗后复发转移性乳腺癌患者分入NX组和GP组,其中NX组18例,长春瑞滨(Vinorelbine,NVB) 25 mg/m²,第1天和第8天,卡培他滨(Capecitabine,Xeloda) 2000 mg/m²,分两次口服,第1～14天,每21天为一周期;GP组23例,吉西他滨(Gemcitabine,GEM) 1000 mg/m²第1天和第8天,顺铂(Cisplatin,DDP) 20 mg/m²,静脉滴注,第2～5天,21天为一周期。化疗过程中注意观察不良反应,根据不良反应的程度调整药物用量。每两周期评价疗效。结果: 41例患者均可评价疗效,NX组CR 1例(5.5%),PR 9例(50%),SD 4例(22.2%),PD 4例(22.2%),RR 55.5%,TTP 6.3 个月;GP组CR 2例(8.9%),PR 11例(47.8%),SD 5例(21.7%),PD 5例(21.7%),RR 56.5%,TTP 6.5 个月。两组间RR及TTP差异无统计学意义(P>0.05);常见的不良反应主要为骨髓抑制、胃肠道反应、手足综合症、静脉炎等。GP组的血小板下降发生率及消化道反应发生率高于NX组,差异有统计学意义(P<0.05),NX组的手足综合症发生率明显高于GP组,差异有明显统计学意义(P<0.01)。结论: NX方案和GP方案用于蒽环类及紫杉类药物治疗后复发转移乳腺癌疗效确切,其血液学和非血液学毒性能够耐受。

关键词: 转移性乳腺癌, 长春瑞滨, 卡培他滨, 吉西他滨

Abstract: AIM: To observe the clinical efficacy and security of vinorelbine combined with capecitabine (NX) and gemcitabine combined with cisplatin(GP) for recurrent metastatic breast cancer after anthracycline- and taxane- treatment (ATRMBC).METHODS: 41 ATRMBC patients were divided into NX group(18 cases) and GP group(23 cases).NX group:capecitabine 2000 mg/m² orally days 1-14 and vinorelbine 25 mg/m² intravenously days 1 and 8,21 days was a cycle.GP group:cisplatin 20 mg/m² intravenously days 2 through 5 and gemcitabine intravenously 1000 mg/m² on days 1 and 8,21 days was a cycle.The dose was adjusted according to adverse effects.The efficacy was evaluated every 2 cycles.RESULTS: All patients were eval- uated for efficacy and toxicity. NX group:one of the 18 patients (5.5%) showed complete response, while 9 patients (50%) showed partial response; the objective response rate was 55.5%. Stable and progressive disease was observed in 4(22.2%) and 4 patients (22.2%), respectively.The median time to progression was 6.3 months;GP group:an objective response was achieved in 13 patients (56.5%). A complete response was achieved in 2 patients (8.9%); partial response in 11 patients (47.8%);stable disease in 5 patients (21.7%), and progressive disease was observed in 5 patients (21.7%).The median time to progression was 6.5 months.There was no significant difference between both groups(P>0.05).The common toxicities included myelosuppression,gastrointestinal reactions,hand-foot syndrome,phlebitis.The incidence rates of platelet decreased and the incidence rate of gastrointestinal reactions in GP group were higher than those in NX group, and there were differences between the two groups (P<0.05),the incidence rate of hand-foot syndrome in NX group was higer than that in GP group, and there were significant differences between the two groups(P<0.01).CONCLUSION: Vinorelbine combined with capecitabine (NX) and gemcitabine combined with cisplatin(GP) are effective for patients with ATRMBC.The hematologic and non-hematologic toxicities are well tolerated.

Key words: Metastatic breast cancer, Vinorelbine, Capecitabine, Gemcitabine

中图分类号:

R737.9

朱益平, 盛莉莉, 王路, 吉兆宁. NX方案和GP方案治疗蒽环类及紫杉类药物治疗后复发转移乳腺癌的临床疗效分析[J]. 中国临床药理学与治疗学, 2013, 18(8): 918-923.

ZHU Yi-ping, SHENG Li-li, WANG Lu, JI Zhao-ning. Analysis on clinical efficacy of vinorelbine combined with capecitabine (NX) and gemcitabine combined with cisplatin(GP) for recurrent metastatic breast cancer after anthracycline- and taxane- treatment[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2013, 18(8): 918-923.

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