长春瑞滨联合紫杉醇治疗晚期乳腺癌

背景与目的：长春瑞滨（商品名诺维本、NVB）其作用阻滞微管蛋白聚合和诱导微管的解聚，而紫杉醇相反，它促进微管蛋白的聚合，阻微管正常的生理性解聚：本文观察长春瑞滨联合紫杉醇治疗晚期乳腺癌的临床疗效疗效和毒副反应方法：42例经病理学和细胞学证实的晚期乳腺癌患者应用长春瑞滨25mg/m^2，静脉滴注，第1、8d；紫杉醇175mg/m^2，静脉滴注3h，第1天；在紫杉醇静脉滴注之前12h、6h，分别口服地塞米松20mg，给药前30min肌注非那根25mg和西米替丁300mg静脉滴注。21d为一个周期，完成2～4个周期后评价疗效：结果：全组总缓解率（RR）66．7％，填中完全缓解率（CR）16．7％，初次化疗患者RR72．2％，CR27．7％；再次化疔患者RR62．1％，CR8．3％，2，4年生存率分别为40．5％（17／42）和21．4％（9／42）；中位缓解期为8个月（5～17个月），中化生存期为18个月；主要毒副反应为骨髓抑制，脱发和周围静脉炎：结论：长春瑞滨联合紫杉醇方案治疗晚期乳腺癌有很好的疗效，且毒副反心患者可耐受。

Clinical study of navelbine plus paclitaxel for patients with advanced breast cancer

Background and purpose:The mechanism of vinorelbine is inhibition of microtubule protein assembly and inducetion of the disaggreation of microtubles;where as docetaxed promotes the assembly of microtuble protein and inhibits normal physiological disaggreation of tubulin.We studied the curative effect and toxicity of combination of chemotherapy with navelbine(NVB) plus paclitaxel in the treatment of advanced breast cancer.Methods:Forty-two pathologically and cytologically proved cases of advanced breast cancer were treated with intravenous infusion of navelbine 25mg/m~2 on d1 and d8,paclitaxel 175mg/m~2 by 3-hour continuous infusion on d1.Interval between each cycle was 21 days and the clinical response and the toxicity were assessed after 2~4 cycles.Results:The overall response rate(RR) for the whole group of patients was 66.7% with 16.7% complete response(CR).In the first time chemotherapy patients,the RR was 72.2% with 27.2% CR;while in those with prior chemotherapy,an RR as high as 62.5% with 8.3% CR was also obtained.The 2-and 4-year survival rates was 40.5% and 21.4%,the median remission period was 8 months,the median overall survival duration was 18 months.The major side effects include leukopenia,hairloss,milieu phlebitis.Conclusions:The combination chemotherapy with navelbine and paclitaxel in treatment of advanced breast cancer is effective and the side effects could be tolerated.