培美曲塞联合华蟾素为晚期或转移性乳腺癌患者一线治疗的疗效和安全性

目的观察培美曲塞联合华蟾素治疗晚期或转移性乳腺癌患者的的疗效和安全性。 方法选取2012年2月至2016年4月间武汉市黄陂区人民医院外科收治的晚期或转移性乳腺癌女性患者138例，随机分为观察组和对照组各69例，分别经培美曲塞联合华蟾素、培美曲塞结合顺铂（DDP）治疗。对治疗效果、不良反应、癌胚抗原（CEA）及CA153水平进行观察比较，采用实体瘤疗效评估标准（RECIST 1.0）进行疗效评价。 结果观察组治疗后CA153水平由（47.63±5.28）U/ml降至（26.51±4.34）U/ml，CEA水平由（24.68±3.14）μg/L降至（8.83±2.45）μg/L；对照组CA153水平由（47.52±5.44）U/ml降至（34.58±4.92）U/ml，CEA水平由（23.75±3.20）μg/L降至（16.58±2.17）μg/L；治疗前两组差异无统计学意义，治疗后差异均有统计学意义（t=10.218、19.670，P=0.000、0.000）。观察组治疗后控制率、有效率分别为65.22%（45/69）、33.33%（23/69），对照组分别为44.93%（31/69）、20.29%（14/69），差异有统计学意义（χ²=5.740、4.333，P=0.017、0.037）。观察组恶心、呕吐、血小板减少、粒细胞减少、肝肾功能异常、脱发的发生率分别为46.38%、23.19%、37.68%、17.39%、2.90%，对照组分别为73.91%、47.83%、65.22%、36.23%、15.94%，差异有统计学意义（χ²=14.935，P<0.001）。 结论培美曲塞联合华蟾素作为晚期或转移性乳腺癌患者一线治疗的疗效较佳，可有效降低不良反应发生率，安全性高，适合临床推广。

Efficacy and safety of pemetrexed combined with cinobufacini in the first-line treatment of advanced or metastatic breast cancer

ObjectiveTo investigate the efficacy and safety of pemetrexed combined with cinobufacini in the first-line treatment of patients with advanced or metastatic breast cancer. MethodsA total of one hundred and thirty-eight women with advanced or metastatic breast cancer were randomly divided into two groups: observation group and control group, treated with pemetrexed combined with cinobufacini and pemetrexed in combination with cisplatin (DDP), respectively. The therapeutic effect, adverse reactions, carcinoembryonic antigen (CEA) and CA153 were observed and compared, and the curative effect evaluation standard (RECIST 1.0) was used to evaluate the curative effect. ResultsIn the observation group, the level of CA153 was decreased from (47.63±5.28) U/ml to (26.51±4.34) U/ml, and CEA decreased from (24.68±3.14) μg/L to (8.83±2.45) μg/L. The level of CA153 in the control group was decreased from (47.52±5.44) U/ml to (34.58±4.92) U/ml, and CEA decreased from (23.75±3.20) μg/L to (16.58±2.17) μg/L. There were significant differences between two groups after the treatment (t=10.218, 19.670, both P=0.000). The control rate and efficacy of the observation group was 65.22%(45/69) and 33.33%(23/69), while the control group 44.93%(31/69) and 20.29%(14/69), with significant differences (χ²=5.740, 4.333, P=0.017, 0.037). The incidence of nausea and vomiting, thrombocytopenia, granulocyte reduction, liver and kidney dysfunction and hair loss was 46.38%, 23.19%, 37.68%, 17.39%, 2.90% in the observation group, while 73.91%, 47.83%, 65.22%, 36.23%, 15.94% in the control group, with significant difference (χ²=14.935, P<0.001). ConclusionPemetrexed combined with cinobufacini shows good efficacy as a first-line treatment for late or metastatic breast cancer patients, and can effectively reduce the incidence of adverse reactions, with high safety and suitable for clinical promotion.