卡培他滨维持治疗晚期乳腺癌的临床观察

背景与目的：卡培他滨是晚期乳腺癌一线治疗方案用药，但在晚期乳腺癌的维持治疗中的研究较少。本文旨在探讨卡培他滨维持治疗晚期乳腺癌的疗效及不良反应。方法：将一线化疗后处于完全缓解(complete response，CR)、部分缓解(partial response，PR)或疾病稳定(stable disease，SD)的62例患者分为2组，卡培他滨治疗组(31例)患者予以单药口服卡培他滨维持治疗，对照组(31例)患者予以定期随访观察。每2个化疗周期后评价疗效。结果：卡培他滨治疗组中位疾病进展时间(time to progression，TTP)为12(2～24)个月，明显高于对照组的7(1～18)个月，且2组差异有统计学意义(P<0.05)。在亚组分析中，未绝经组、激素受体阳性组、HER-2阳性组、有内脏转移组、有肺转移组及既往未接受过卡培他滨化疗组的患者中，卡培他滨治疗组患者的TTP均显著高于对照组患者。卡培他滨治疗组总有效率(CR+PR)为19.4%(6/31)，肿瘤控制率(CR+PR+SD)为74.2%(23/31)。主要不良反应为手足综合征及血液学不良反应，其次为胃肠道不良反应，但均可以耐受。卡培他滨治疗组的生活质量评分较对照组明显提高。结论：卡培他滨用于晚期乳腺癌一线治疗后的维持治疗可以延缓疾病进展，提高生活质量。

Clinical observation of capecitabine in the maintenance treatment of advanced breast cancer

Background and purpose: Capecitabine, which is widely used in the first-line treatment of advanced breast cancer, was known little in the maintenance treatment of advanced breast cancer. The present study aimed to explore the efficacy and safety of capecitabine in the maintenance treatment of advanced breast cancer. Methods: A total of 62 advanced breast cancer patients confirmed by histopathology and/or cytology, who had been evaluated as CR/PR/SD after first-line treatment, were divided into two groups. Thirty-one of them received capecitabine orally as maintenance treatment, while the others were followed up without any treatment. The clinical response was evaluated every two cycles. Results: The median time to progression (TTP) of the capecitabine group was 12 (2-24) months, which was significantly higher than the control group. In the subgroup analysis, similar results were detected in the premenopausal group, hormone receptor positive group, HER-2 positive group, metastasis group, no capecitabine used history group. Among the capecitabine group，the overall response rate (CR+PR) was 19.4%, and the disease control rate (CR+PR+SD) was 74.2%. The most common adverse effects were hand-foot syndrome, hematologic toxicity and gastrointestinal reaction, all of which could be tolerated. The overall score of the capecitabine group evaluated by the Chinese vesion of the FACT-B was significantly higher than the control group. Conclusion: Capecitabine can effectively and tolerably prolong survival time and improve the quality of life of patients in the maintenance treatment of advanced breast cancer.