吉西他滨联合卡培他滨治疗紫杉类化疗失败的晚期乳腺癌的临床观察

目的探讨吉西他滨联合卡培他滨治疗紫杉类治疗失败的晚期乳腺癌的临床疗效及不良反应。方法对2008年3月至2010年2月住院治疗的69例紫衫类及葸环类治疗失败的晚期乳腺癌患者给予吉西他滨（1000mg／m2）和卡培他滨（1500mg／m2）治疗,3周为1个疗程,至少经过2个疗程的治疗。结果完全缓解3例（4．3％）,部分缓解27例（39．1％）,稳定22例（31．9％）,进展17例（24．6％）,总有效率为43．5％,临床获益率为75．4％,中位无进展生存时间为8．2个月,中位生存时间为13．4个月。骨转移患者总有效率为100％,明显高于多发转移、肺部转移和肝脏转移等患者,差异有统计学意义（P〈0．05）。绝经前患者临床获益率明显高于绝经后患者,两组比较差异有统计学意义（P〈0．05）。不良反应以手足综合征和血小板减少为主,均为可逆性,无治疗相关死亡发生。结论吉西他滨联合卡培他滨治疗紫杉类化疗失败的晚期乳腺癌临床效果显著,对于骨转移患者和绝经前患者的治疗效果更佳。

Clinical effect of gemcitabine combined with capecitabine in taxane refractory metastatic breast cancer

Objective Discuss the clinical effect of gemcitabine and capecitabine in treatment of taxane refractory metastatic breast cancer.Methods 69 patients with metastatic breast cancer from Mar,2008 to Feb,2010 were studied,all the patients were treated with gemcitabine(1000mg/m2)and capecitabine(1000mg/m2),three weeks as a therapeutic cyclic,at least two cyclic were needed.ResultsCR 3 cases(4.3%),PR 27 cases(39.1%),SD 22 cases(31.9%),PD 17 cases(24.6%),the ORR was 43.5%,and DCR was 75.4%,mPFS was 8.2 months and mOS was 13.4 months.Among the patients,bone metastasis got the best ORR,which was better than others,the differences were statistically significant(P<0.05);the DCR of patient without menopause was higher than the others.the differences were statistically significant between the two groups(P<0.05);The most common side effects were hand and foot syndrome and the decrease of PLT,no deaths occurred.Conclusions Gemcitabine and capecitabine shows satisfactory clinical efficacy in treatment of taxane refractory metastatic breast cancer.Especially for bone metastasis and patients without menopause,side effect was accepted,and it was worthy of clinical use.