新辅助化疗方案TE与FEC治疗局部晚期乳腺癌疗效观察

目的探讨多西他赛联合表柔比星(TE)与环磷酰胺联合表柔比星、氟尿嘧啶(FEC)不同化疗方案治疗局部晚期乳腺癌近期疗效及发生不良反应情况。方法回顾性分析86例Ⅱb-Ⅲc期局部晚期乳腺癌患者资料,随机分组,多西他赛联合表柔比星治疗患者38例为观察组,环磷酰胺联合表柔比星、氟尿嘧啶治疗患者48例为对照组,每化疗2个疗程进行疗效评估及不良反应分析。结果观察组治疗局部晚期乳腺癌总有效率89.47%,对照组70.83%,两组之间比较有显著性差异(P<0.05);化疗不良反应以脱发、恶心呕吐、中性粒细胞减少症发生率高,但两组间比较无显著性差异(P>0.05)。结论多西他赛联合表柔比星方案治疗局部晚期乳腺癌的新辅助化疗中,临床近期疗效显著。     

多西他赛、表柔比星、环磷酰胺新辅助化疗治疗晚期乳腺癌近期疗效观察

目的探讨多西他赛、表柔比星、环磷酰胺新辅助化疗治疗晚期乳腺癌的近期疗效。方法选择2010年4月~2015年1月本院收治的Ⅱ、Ⅲ期乳腺癌患者80例,按照随机数字表法分为两组,各40例,观察组实施多西他赛、表柔比星、环磷酰胺新辅助化疗方案,对照组使用紫杉醇,多柔比星及环磷酰胺化疗,比较两者完全缓解、部分缓解、病情稳定、疾病进展比例,计算总有效率,统计毒副作用,并比较两组化疗后实施根治性手术间隔时间、病理完全缓解率及1年生存率。结果观察组总有效率达到87.%,显著高于对照组的60.0%(P0.05),观察组发生肝肾功能损伤、心脏毒性及脱发的比例显著低于对照组(P0.05),观察组化疗后实施根治性手术间隔时间显著短于对照组(P0.05),病理完全缓解率显著高于对照组(P0.05),1年生存率显著高于对照组(P0.05)。结论多西他赛、表柔比星、环磷酰胺新辅助化疗方案治疗Ⅱ、Ⅲ期乳腺癌,能有效提高化疗有效率,减少治疗毒副作用,为手术切除创造机会,从而提高病理完全缓解率,延长患者生存时间。     

多西他赛、表柔比星及环磷酰胺联合化疗对乳腺癌新辅助化疗患者疗效观察

目的:探讨乳腺癌新辅助化疗患者采用多西他赛、表柔比星、环磷酰胺联合化疗的疗效。方法:72例乳腺癌新辅助化疗患者按入院先后顺序分为观察组和对照组各36例。两组均行手术治疗,并在手术前后分别进行6个周期的化疗。观察组采用多西他赛、表柔比星及环磷酰胺联合化疗;对照组采用多西他赛与表柔比星联合化疗。比较两组患者的疗效以及不良反应。结果:观察组疗效总体分布明显优于对照组(P<0.05),且显效率、总有效率均高于对照组(P<0.05)。观察组患者中性粒细胞减少发生率明显高于高于对照组(P<0.05),其他各项不良反应发生情况两组比较,差异无统计学意义(P>0.05)。结论:乳腺癌新辅助化疗患者采用多西他赛、表柔比星及环磷酰胺联合化疗,疗效明显优于多西他赛与表柔比星联合化疗,且不良反应并无显著增加,值得临床推广。     

多西他赛联合表柔比星治疗乳腺癌

目的观察多西他赛与表柔比星联合辅助化疗治疗乳腺癌的临床疗效。方法从我院收治入院的乳腺癌拟行化疗患者中抽取60例,随机分为观察组与对照组,观察组使用多西他赛与表柔比星联合化疗,对照组使用表柔比星、氟尿嘧啶与环磷酰胺联合化疗,对比观察两组患者临床疗效。结果观察组患者治疗总有效率明显高于对照组,差异有统计学意义(P<0.05)。结论使多西他赛与表柔比星联合应用,在对乳腺癌患者的化疗中,具有更为显著的临床疗效,且无严重副作用,安全可靠,可以在临床上进一步推广应用。     

TA与AC方案在乳腺癌新辅助化疗中应用的临床观察

目的观察分析TA、AC两种新辅助化疗方案的临床效果,以期为临床合理治疗乳腺癌提供依据。方法依据纳入/排除标准共选取70例女性乳腺癌患者并随机分为2组,观察组采用多西他赛+表柔比星治疗方案,对照组采用环磷酰胺+表柔比星治疗方案;比较两组临床疗效及化疗期间不良反应发生情况。结果观察组治疗有效率为88.6%,对照组为68.6%,两组比较差异有统计学意义(P<0.05);两组疾病控制率分别为100%、94.3%,差异无统计学意义(P>0.05);两组治疗期间不良反应发生情况比较亦无统计学差异(P>0.05)。结论多西他赛、表柔比星联合用于乳腺癌新辅助化疗临床效果较为理想,可显著提高治疗有效率,值得临床推广应用。     

表柔比星联用紫杉醇或多西他赛在Ⅲ期乳腺癌新辅助化疗中的疗效研究

目的分析表柔比星联用紫杉醇或多西他赛在Ⅲ期乳腺癌新辅助化疗中的疗效,为临床提供指导。方法抽取入住我院的54例Ⅲ期乳腺癌患者(2010年7月至2015年7月)作为本次实验的研究对象,对54例Ⅲ期乳腺癌患者实施随机分组(A组和B组)。A组27例Ⅲ期乳腺癌患者采取表柔比星联用紫杉醇进行治疗,B组27例Ⅲ期乳腺癌患者采取表柔比星联用多西他赛进行治疗,分析比较两组Ⅲ期乳腺癌患者的近期疗效及不良反应发生率。结果 A组Ⅲ期乳腺癌患者的不良反应发生率(37.04%)和B组无明显区别,且两组Ⅲ期乳腺癌患者的近期疗效不存在明显差异,P>0.05。结论对Ⅲ期乳腺癌患者采取表柔比星联用紫杉醇或多西他赛进行治疗,效果无明显区别,患者均可耐受毒性反应。     

2种多西他赛联合表柔比星方案新辅助化疗乳腺癌疗效与安全性的比较

目的;观察2种多西他赛联合表柔比星方案新辅助化疗乳腺癌的近期疗效和毒副反应。方法:78例局部晚期乳腺癌患者随机分为TEC组(45例)和TE组(33例)。TEC组患者给予多西他赛注射液75 mg/m2,静脉滴注,d1+注射用盐酸表柔比星60 mg/m2,静脉滴注,d1+注射用环磷酰胺500 mg/m2,静脉推注,d1;TE组患者给予多西他赛注射液+注射用盐酸表柔比星(用法用量同TEC组)。两组患者均治疗21 d为1个周期,共4~6个周期。所有患者完成至少4个周期后评价疗效和毒副反应,并随访6个月生存率。结果:两组患者的近期疗效、毒副反应、生存率比较,差异均无统计学意义(P>0.05)。结论 :TEC和TE方案治疗乳腺癌的近期疗效和安全性均相当,均可作为新辅助化疗的辅助药物。     

多西他赛与表柔比星在乳腺癌保乳术后辅助化疗中的效果与药副反应分析

目的:探究对乳腺癌保乳术患者,在术后辅助化疗中,采用多西他赛和表柔比星的效果以及药副反应.方法:随机选取2016年11月到2017年11月40例乳腺癌保乳术的患者,20例采用多西他赛联合卡铂治疗的患者为常规组,另20例采用多西他赛和表柔比星治疗的患者为研究组,评估治疗效果和药物不良反应.结果:在肿瘤局部复发率、远处转移率上,研究组明显低于常规组,在无病生存时间上,研究组明显长于观察组,差异具有统计学意义(P<0.05).在总生存时间上,两组患者比较,差异没有统计学意义(P>0.05).在不良反应发生率上,研究组明显低于常规组,差异具有统计学意义(P<0.05).结论:对乳腺癌保乳术患者,在术后辅助化疗中,采用多西他赛和表柔比星的效果好,不良反应少.     

辅助化疗TEC方案治疗局部晚期乳腺癌的疗效观察

目的 观察采用多西他赛、表柔比星联合环磷酰胺辅助化疗(TEC)治疗局部晚期乳腺癌的临床疗效.方法 回顾性分析我院49例应用CAF和TEC化疗方案的Ⅱb~Ⅲc期局部晚期乳腺癌患者资料,分为观察组(24例)和对照组(25例).观察组采用多西他赛、表柔比星联合环磷酰胺(TEC)化疗方案,对照组应用5-氟尿嘧啶联合吡柔比星、环磷酰胺(CAF)化疗方案.3周为1疗程,治疗3个疗程后观察统计两组患者化疗效果及毒副作用.结果 对照组总有效率为50.00%,观察组高达80.00%,两组总有效率比较差异有统计学意义(P＜0.05);对照组与观察组毒副反应发生率分别为22.5%和8.9%,比较差异有统计学意义(P＜0.05).结论 应用TEC方案治疗局部晚期乳腺癌疗效显著,且耐受性良好.     

NE方案和AT方案治疗晚期乳腺癌近期疗效观察

目的观察NE与AT方案治疗晚期乳腺癌的近期疗效及不良反应。方法 54例晚期乳腺癌患者随机分组,NE（盖诺联合表柔比星）组33例,AT（多西他赛联合表柔比星）组21例。化疗2个周期后评价疗效。结果 NE组与AT组总有效率分别为48.4%和47.4%,两组比较差异无统计学意义（P〉0.05）。主要不良反应为消化道反应及血液学毒性,两组比较差异无统计学意义（P〉0.05）。结论 NE方案和AT方案治疗晚期乳腺癌近期疗效肯定,不良反应可耐受。     

Docetaxel and epirubicin salvage regimen in relapsed anthracycline-sensitive metastatic breast cancer patients after anthracycline-containing adjuvant therapy

Summary  Our aim in this paper is to verify the efficacy and safety of a epirubicin and docetaxel salvage regimen for anthracycline sensitive metastatic breast cancer patients who have relapsed after anthracycline-containing adjuvant therapy. Thirty-two metastatic breast cancer patients were treated with epirubicin and docetaxel every 21 days. Of the 31 evaluable patients, there were 13/31 (41.9%) partial responses and no complete responses. Median time to progression was 12 months (95% CI, 4–60 months) and median survival duration was 41 months (95% CI, 1.2–80.8 months). According to the Cox model, ECOG performance and response group were statistically significant variables, and visceral metastasis was a borderline significant variable with regards to overall survival. Although this salvage regimen showed a high rate of hematologic toxicities, it was a relatively active regimen with manageable toxicities and no cardiac dysfunction. We propose that this salvage regimen could be carefully used in anthracycline sensitive metastatic breast cancer patients who have relapsed after anthracycline-containing adjuvant therapy.     

Capecitabine: new indication. In breast cancer: inadequately assessed

There is no consensus on treatment of locally advanced or metastatic breast cancer after failure of first-line cytotoxic chemotherapy. Common options are continuous infusion of a taxane (docetaxel or paclitaxel), vinorelbine or fluorouracil. Capecitabine is now licensed for use in breast cancer, both in combination with IV docetaxel after anthracycline failure, and as single-agent therapy after failure of anthracyclines and taxanes. The clinical evaluation dossier on capecitabine fails to answer the most important questions about comparative efficacy and safety. In second-line treatment, after anthracycline failure, the only available comparative trial showed that the capecitabine + docetaxel combination increased median survival time by about three months relative to placebo + docetaxel, but caused more adverse events. There are no trials comparing capecitabine with other options. There is no evidence that capecitabine increases the length or quality of survival, relative to intravenous vinorelbine, in women with breast cancer that is resistant to both anthracyclines and taxanes. The classical adverse effects of capecitabine are also observed in women with breast cancer, namely palmoplantar erythrodysesthesia, diarrhoea, nausea and vomiting, and major hyperbilirubinemia. Capecitabine can be taken by mouth and this may be an advantage. However, current evidence is too limited to justify using capecitabine outside of clinical trials.     

Trials of new combinations of Herceptin in metastatic breast cancer

Herceptin extends survival in human epidermal growth factor receptor-2 (HER2)-positive metastatic breast cancer patients when administered with paclitaxel or anthracycline/cyclophosphamide (AC), and the combination with 3-weekly paclitaxel is the current standard first-line therapy. However, other combinations may be equally effective. This review provides information on recent and ongoing trials of new Herceptin combinations. Preliminary results indicate that Herceptin plus epirubicin/cyclophosphamide may be effective without the cardiotoxicity of the AC combination. Weekly paclitaxel plus Herceptin has produced responses in 83% of HER2-positive patients treated. Co-administering Herceptin with other cytotoxic agents has also been investigated, with combination partners being chosen based on in vitro synergy with Herceptin, known efficacy as monotherapy and convenience of weekly administration (e.g. docetaxel, vinorelbine). High response rates have been observed in these clinical trials, e.g. up to 80% in combination with vinorelbine. Furthermore, Herceptin in combination with weekly paclitaxel, docetaxel or vinorelbine was well tolerated: there was no significant cardiotoxicity or unexpected toxicity and the combination showed an adverse event profile similar to that seen with monotherapy with the cytotoxic agent. Thus, Herceptin produces additional clinical benefit when added to all the cytotoxic agents with which it has been examined, further demonstrating its potential for use in HER2-positive breast cancer patients.     

多西紫杉醇联合吉西他滨治疗蒽环类耐药性晚期乳腺癌的疗效分析

目的观察多西紫杉醇（DXL）联合吉西他滨（Gemcitabine）方案治疗蒽环类耐药性晚期乳腺癌的临床疗效与毒副作用。方法将我院2004年1月-2008年6月收治的蒽环类耐药性晚期乳腺癌患者85例,随机分成两组,多西紫杉醇治疗（DT）组42例,多西紫杉醇联合吉西他滨治疗（DGT）组43列。DT组用多西紫杉醇75mg／m^2,静滴,第1天,21d为1周期;DGT组用多西紫杉醇75mg／m^2,静滴,第1天,吉西他滨1000mg／m^2,静滴,第1天和第8天,21d为1周期。两组中位化疗周期数均为6周期,检测指标为疗效、无进展生存期（progression free survival,PFS）.结果DT组和DGT组的中位无进展生存期分别为（6．78±0．54）个月与（9．69±0．65）个月,两者比较差异有显著性（P〈0．05）.DT组疗效为总有效率（CR＋PR）为47．6％,DGT组总有效率（CR＋PR）为62．8％,两者比较差异有显著性（P〈0．05）.两组的主要毒副作用为胃肠道反应和骨髓抑制反应。结论多西紫杉醇联合吉西他滨化疗方案治疗蒽环类耐药的晚期乳腺癌疗效好,无交叉耐药性,不良反应轻,是蒽环类耐药性乳腺癌的有效治疗方案。     

TE与TEC2种新辅助化疗方案治疗乳腺癌的疗效观察

目的:观察多西他赛+吡柔比星(TE)与多西他赛+吡柔比星+环磷酰胺(TEC)2种新辅助化疗方案治疗乳腺癌的近期疗效和安全性。方法:回顾性分析2009年11月-2011年3月间我院收治的92例Ⅱ、Ⅲ期乳腺癌患者的临床病理资料,依据患者术前接受的新辅助化疗方案分为TE组(49例)与TEC组(43例)。TE方案:多西他赛75mg·m-2,第1天静脉滴注;吡柔比星50mg·m-2,第1天静脉滴注。TEC方案:多西他赛75mg·m-2,第1天静脉滴注,吡柔比星50mg·m-2,第1天静脉滴注;环磷酰胺600mg·m-2,第1天静脉滴注。以上方案均21d为1个周期,2组患者均在术前接受4个周期化疗,并在术后完成剩余化疗周期。4个周期后观察疗效,并评估不良反应,同时,通过随访对无病生存时间(DFS)和总生存时间(OS)进行评价。结果:TE组有效率为83.67%,TEC组为88.37%,2组差异无统计学意义(P=0.146);TE组病理完全缓解率为12.24%,TEC组为13.95%,2组差异无统计学意义(P=0.607)。2组主要不良反应均为中性粒细胞减少、脱发、恶心及呕吐、肝功能异常、心肌毒性,其中中性粒细胞减少TEC组发生率明显高于TE组,2组差异有统计学意义(P=0.026)。中位随访13(5～21)个月,2组DFS和OS差异无统计学意义(P=0.083和P=0.071)。结论:在Ⅱ、Ⅲ期乳腺癌患者新辅助化疗中,TE与TEC2种方案近期疗效相近,但TE方案较TEC方案更安全。     

The role of taxanes in breast cancer treatment

Cancer of the breast is a serious public health problem throughout the world. Chemotherapy remains the mainstay of treatment of both early stage and metastatic breast cancer. New advances in chemotherapy include paclitaxel and docetaxel. This article reviews the historical background to the introduction of these highly active agents, their biochemistry, mechanism of action and pharmacology, dose and schedule in the treatment of breast cancer, first- and second-line use as well as anthracycline/taxane combinations. Adjuvant, neoadjuvant use and the emergence of weekly taxanes is discussed. (c) 2001 Prous Science. All rights reserved.     

卡培他滨单药用于一线治疗后复发乳腺癌疗效观察

目的:探讨卡堵他滨单药1线治疗后复发晚期乳腺癌的近期疗效.方法:全组27例1线治疗后复发的乳腺癌,卡培他滨2500 mg/(m2·d),分早晚2次口服,连服14天,21天为1个周期,治疗至少2个周期后评价疗效及不良反应.结果:24例可评价疗效,全组无完全缓解(CR),部份缓解(PR)7例(29.1%),稳定(SD)10例(41.8%),进展(PD)7例(29.1%),总有效率为29.1%.主要的不良反应为手足综合征(54.1%)、恶心呕吐(29.1%).结论:卡培他滨对经蒽环类、紫杉类等药物治疗后复发的晚期乳腺癌仍有较好疗效,且不良反应小,耐受性好,可作为复发的晚期乳腺癌的二线治疗方案.     

多西他赛为主的联合方案一线治疗晚期乳腺癌的临床观察

目的：观察多西他赛联合表阿霉素或顺铂一线治疗晚期乳腺癌的疗效和安全性。方法：62例晚期乳腺癌患者,将既往用蒽环类药物辅助化疗后转移的29例患者及3例不宜用蒽环类药物且未接受过辅助化疗的患者,予多西他赛联合顺铂（TP方案）化疗;将既往用CMF方案辅助化疗后转移的17例患者及13例既往未接受过辅助化疗的患者,予多西他赛联合表阿霉素（TE方案）化疗。TE组药物剂量多西他赛75mg.（m^2）^-1,表阿霉素60mg·（m^2）^-1,d1;TP组药物剂量为多西他赛75mg·（m^2）-1,d1,顺铂25mg·（m^2）^-1,d1～3,21天为1周期,2个周期末评价近期疗效及安全性。结果：62例患者均可评价疗效,其中CR7例,PR29例,SD17例,PD9例,总有效率为58.1%,TE组和TP组有效率分别为60.0%和56.3%（P=0.963）,临床受益率分别为86.7%和84.4%（P=0.897）,TTP分别为10.2个月和9.0个月（P=0.713）。不良反应主要是骨髓抑制、脱发、消化道反应,但均可耐受,无化疗相关死亡。结论：多西他赛联合表阿霉素或顺铂方案一线治疗晚期乳腺癌有较好的疗效,不良反应可以耐受,且TE和TP方案的疗效及安全性相当。