卡培他滨单药或联合用药治疗复发／转移性乳腺癌的疗效观察

目的评价卡培他滨（capecitabine）单药或联合用药作为姑息方案治疗复发／转移性乳腺癌的近期疗效和毒副反应。方法卡培他滨单药方案：20例患者每天予卡培他滨2510mg／m2，分早、晚2次口服，连续服用2周后休息1周为1个周期。联合用药方案：17例予卡培他滨联合吉西他滨（GX方案）；15例予卡培他滨联合长春瑞滨（NX方案）；20例予卡培他滨联合多西紫杉醇（TX方案）。每例患者至少进行2个周期的治疗。结果卡培他滨单药方案的有效率为25．0％，中位疾病进展期（TTP）为3．2个月。联合方案中GX方案的有效率为29．4％，TTP为3．7个月；NX方案的有效率为26．7％，TTP为3．5个月；TX方案的有效率为35．0％，TTP为3．8个月。主要毒副反应为白细胞减少、手足综合征、皮肤色素沉着、恶心、呕吐、厌食、疲劳等，少数患者出现口腔炎、头晕、腹泻和胸闷。Ⅲ～IV级毒副反应主要发生在TX方案，发生率为15％。结论作为姑息治疗方案，卡培他滨单药或联合用药治疗复发／转移性乳腺癌的有效率均≥25％，联合用药组的有效率比单药组提高，疾病控制的时间联合用药组较单药组延长。患者对卡培他滨单药及联合用药的毒副反应均可耐受。

Comparison of capecitabine in mono-or polytherapy to manage patients with recurrent and metastatic breast cancer

Objective To compare the therapeutic and adverse effects of capecitabine alone or in combination with other drugs for treatment of recurrent and metastatic breast cancer. Methods A capecitabine monotherapy group（n=20）was given the drug at a dose of 2 510mg/m2 twice a day for two weeks,followed by one week of rest as one cycle.Combination therapy groups received capecitabine together with gemcitabine （ GX group, n= 17 ）, vinorelbine （ NX group, n= 15 ） or docetaxel （TX group, n =20 ）.Patients in each group were given at least two treatment cycles. Results In the capecitabine monotherapy group,treatment efficacy was 25%, and median time to progression（TTP） was 3.2 months.Treatment efficacy and median TTP were 29% and 3.7 months for the GX group, 30.8% and 3.5 months for the NX group,and 35% and 3.8 months for the TX group.The results for the combination therapy groups did not differ significantly from those of the monotherapy group.The major adverse drug reactions included leukopenia, handfoot syndrome, skin pigmentation, nausea, vomiting, anorexia and fatigue. In addition, stomatitis, dizziness, diarrhea, and chest tightness were observed in a few patients.Degree III-IV leukopenia occurred mainly in the TX group,where its frequency was 15%. Conclusions Capecitabine monotherapy or capecitabine-based polytherapy can achieve treatment efficacy rates above 25% against recurrent and metastatic breast cancer.Combination therapy was associated with slightly higher efficacy rates and longer remission time than was monotherapy, but these differences did not achieve statistical significance.Both capecitabine mono-and polytherapy are well tolerated in patients.