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目的 观察甲酰四氢叶酸钙(CF)联合5-氟尿嘧啶(5-Fu)治疗晚期乳腺癌的疗效和安全性.方法 选择既往经过蒽环类、紫杉类等药物治疗无效的晚期乳腺癌31例,中位年龄48.0岁(27～66岁).采用CF联合5-Fu化疗方案治疗.CF[150 mg/(m2·d)]+ 5-Fu[600 mg/(m2·d)],连用5天,每天静脉滴注不少于12h,每4周为一周期.观察有效率及不良反应.结果 完全缓解2例(6.5％),部分缓解7例(22.6％),病情稳定6例(19.4％),进展16例(51.6％).总有效率为29.0％,临床获益率为48.4％,其中激素受体阴性患者更能获益(P＜0.05).中位有效期为2.3月(95％CI:1.1～4.1),中位生存期为9.5月(95％CI:4.7～14.8).15例(48.4％)生活质量改善,6例(19.4％)稳定,10例(32.3％)下降.不良反应主要是胃肠道反应(11例)、骨髓抑制(4例)和口腔炎(9例).结论 CF+ 5-Fu联合静脉滴注二线治疗晚期乳腺癌疗效确切,不良反应可控,患者易于耐受,可以作为复发转移的晚期难治性乳腺癌的解救治疗.

Combination of Calcium Folinate and 5-Fluorouracil As Second-line Treatment for Advanced Breast Cancer

Objective To study the clinical efficiency and safety of calcium folinate combined with 5-fluorouracil in advanced breast cancer patients.Methods Thirty-one advanced breast cancer patients were enrolled,with median age was 48.0years(27～66years),who had progressed diseases after treatments of anthracycline compounds and paclitaxel.Estrogen receptor(ER)and(or)progesterone receptor(PR)were positive in 12cases(ER+,9cases;PR+,5cases;ER+and PR+,2cases),ER and PR were negative in 19cases.The patients were treated with CF[150mg/(m2.d)]and 5-Fu[(600mg/(m2.d)]by venous infusion for more than 12hours with D1～5.This therapeutic regimen was 28days per 1cycle.Results Complete response(CR),partial response(PR),stable disease(SD)and progressive disease(PD)was achieved in 2patients(6.4%),7patients(22.58%),6patients(19.35%)and 16patients(51.61%),respectively.Overall response rate(CR+PR)was 29.0% and the clinical benefit rate(CR+PR+SD)was 48.4%.It was more obvious that patients with negative hormone receptor had increased response rate(P <0.05).The median duration of response was 2.3months(95%CI:1.1～4.1)and median survival time was 9.5months(95%CI:4.7～14.8).The quality of life was improved in 15cases(48.4%),stable in 6 cases(19.4%)and decreased in 10cases(32.3%).The main toxic effects were gastrointestinal side-effect(11cases),bone marrow suppression(4cases)and stomatitis(9cases).Conclusion The combination of CF and 5-Fu given by continuous venous infusion every 4weeks was active in terms of objective response rate against advanced breast cancer with well-tolerance.