希罗达联合长春瑞宾二线治疗紫杉类及蒽环类失败复发转移性乳腺癌的疗效观察

目的观察希罗达联合长春瑞宾二线治疗复发转移乳腺癌的临床效果及不良反应发生情况。方法选择32例乳腺癌复发转移性患者，于第1、8天静脉滴注长春瑞宾25mg／m2；早晚2次口服希罗达2000mg／（m2·d），连用2周，休息1周为1个周期。所有患者均行2个以上周期的治疗。结果32例患者中，5例完全缓解（CR），12例部分缓解（PR），11例病情稳定（SD），4例病情进展（PD），总有效率53．12％，临床获益患者（CR＋PR＋SD）28例（87．5％）。患者不良反应为恶心、呕吐、皮肤色素沉着、厌食、手足综合征和疲劳等，小部分患者有头晕、口腔炎、胸闷和腹泻发生，偶见谷丙转氨酶、胆红素轻度升高者，其中轻一中度白细胞下降及贫血者占36．4％。结论对紫杉类及蒽环类治疗失败的复发转移乳腺癌患者，希罗达联合长春瑞宾作为二线治疗方案治疗效果肯定，且不良反应轻，患者能耐受。

Effect of capecitabine combined with vinorelbine on treating the patients with relapsed and metastatic breast cancer

Objectives To evaluate the effect and adverse reactions of capecitabine combined with vinorelbine on treating the recurrent and metastatic breast cancer that failed to the treatment of taxanes and anthracyeline. Methods Thirty-two patients with recurrent or metastatic breast cancer were treated by capecitabine and vinorelbine. Vinorelbine was given at the dose of 25mg/m2 on day Ist and day 8th,and xeloda was given at the dose of 2 000mg/m2/d,twice a day for two weeks followed by one week of rest as a cycle. All patients were treated with two or more cycles. Results Among the 32 patients, five achieved complete re- sponse, 12 achieved partial response. The total response rate was 53. 1% ,and the clinical benefit response （ CR ＋ PR ＋ SD） was 87.5 %. The common adverse reactions were hand-foot syndrome, skin pigmentation, nausea, vomiting, anorexia and fatigue. Mild- moderate anemia and leukopenia were observed in 36.4% of patients. Mild elevation of total bilirubin and alanine transaminase （ALT） occurred in a few patients. Conclusion Capecitabine combined with vinorelbine is an effective ragmen for treating pa- tients with relapsed and metastatic breast cancer, especially for those who have failed to chemotherapy with anthraeycline and tax- anes. The regimen is tolerable while has mild adverse reactions.