多西紫杉醇联合表阿霉素及环磷酰胺治疗晚期乳腺癌的临床观察

目的:观察多西紫杉醇联合表阿霉素及环磷酰胺治疗晚期乳腺癌的疗效与不良反应.方法:采用多西紫杉醇联合表阿霉素及环磷酰胺治疗56例复发或转移的晚期乳腺癌患者,多西紫杉醇75mg/m2,d1,表阿霉素50mg/m2,d1,环磷酰胺500mg/m2,d1,21天为1周期,连续治疗2周期.结果:56例患者TEC方案治疗2周期后CR 7例,PR 22例,总有效率为51.8%.最常见不良反应为骨髓抑制、消化道反应及脱发,本组无一例发生过敏反应,其不良反应可耐受.结论:TEC方案治疗晚期乳腺癌可作为晚期乳腺癌的一线治疗方案.     

周剂量紫杉类药物联合表阿霉素、环磷酰胺治疗乳腺癌的安全性观察

目的 观察周剂量紫杉类药物联合表阿霉素、环磷酰胺(周剂量TEC/DEC)方案治疗乳腺癌的安全性.方法 对19例乳腺癌采用紫杉醇80mg/m2,d1,8,或多西紫杉醇40 mg/m2,d1,8,静脉滴注;表阿霉素55 mg/m2,d1,2,静脉滴注;环磷酰胺800mg/m2,d1,静脉推注.每21d为1周期,应用4～6周期,监测毒副反应.结果 19例乳腺癌除1例第1周期出现频发室性心动过速,拒绝进一步治疗外,其余毒副反应主要为骨髓抑制(94.7%)、消化道反应(52.6%)、谷丙转氨酶升高(78.9%),未见过敏反应出现.其毒副反应经扶正、止吐、升白及保肝治疗后,均未影响下一周期治疗.结论 周剂量TEC/DEC方案治疗乳腺癌毒副反应易于耐受,安全有效,值得进一步推广应用.     

多西紫杉醇联合表阿霉素治疗局部晚期乳腺癌的疗效观察

目的：了解多西紫杉醇加表阿霉素对局部晚期乳腺癌患者进行新辅助化疗的疗效及不良反应。方法：对我院治疗的63例均采用多西紫杉醇加表阿霉素（DE方案：多西紫杉醇75 mg/m2d1,表阿霉素75 mg/m2d1）化疗的局部晚期乳腺癌患进行回顾性分析,每位患者进行2-4疗程的化疗,结束后评估疗效及不良反应。结果：总有效率（CR＋PR）为68.3%,完全缓解（CR）8例,部分缓解（PR）35例,无变化（SD）13例,进展（PD）7例。术后中位随访24个月,死亡6例,复发及转移13例,健在44例。结论：多西紫杉醇联合表阿霉素术前化疗可以使患者降期,使原发灶缩小,以增加手术机会,提高生存率。     

多西紫杉醇联合表阿霉素治疗局部晚期乳腺癌的疗效观察

目的:了解多西紫杉醇加表阿霉素对局部晚期乳腺癌患者进行新辅助化疗的疗效及不良反应。方法:对我院治疗的63例均采用多西紫杉醇加表阿霉素(DE方案:多西紫杉醇75 mg/m2d1,表阿霉素75 mg/m2d1)化疗的局部晚期乳腺癌患进行回顾性分析,每位患者进行2-4疗程的化疗,结束后评估疗效及不良反应。结果:总有效率(CR+PR)为68.3%,完全缓解(CR)8例,部分缓解(PR)35例,无变化(SD)13例,进展(PD)7例。术后中位随访24个月,死亡6例,复发及转移13例,健在44例。结论:多西紫杉醇联合表阿霉素术前化疗可以使患者降期,使原发灶缩小,以增加手术机会,提高生存率。     

多西他赛联合表阿霉素治疗晚期三阴乳腺癌临床观察

目的观察多西他赛联合表阿霉素治疗晚期三阴乳腺癌患者的疗效及不良反应。方法 37例三阴乳腺癌患者给予多西他赛75 mg/m2第1天;表阿霉素60 mg/m2,第2天,21 d为1个周期,至少2个周期化疗。结果 37例患者中完全缓解1例,部分缓解16例,稳定9例,进展11例,有效率为45.9%,疾病控制率为70.3%,中位生存时间为10.8个月。治疗的主要不良反应是骨髓抑制。结论晚期三阴乳腺癌患者预后差,采用多西他赛联合表阿霉素方案治疗安全有效,可延长患者生存时间,不良反应可以接受。     

泰索帝联合表阿霉素、环磷酰胺治疗晚期乳腺癌20例

[目的]观察泰索帝联合表阿霉素、环磷酰胺治疗晚期乳腺癌的临床疗效及不良反应.[方法]对有病理学诊断及可评价客观指标的20例乳腺癌患者,采用泰索帝联合表阿霉素、环磷酰胺方案治疗,泰索帝75mg/m2 d1,静脉滴注4h,用泰索帝前12h、6h分别口服地塞米松20mg,给药前30min给予苯海拉明50ug口服及西米替丁400mg静脉滴注.表阿霉素50mg/m2,环磷酰胺500mg/m2d1静脉滴注,21天为一周期,2周期评价疗效.[结果]完全缓解3例,部分缓解8例,稳定5例,进展4例,有效率为55%,不良反应主要为白细胞减少,Ⅲ度2例,Ⅳ度1例;脱发Ⅱ度10例,Ⅲ度2例;腹泻Ⅱ度9例,Ⅲ度3例.[结论]泰索帝联合表阿霉素、环磷酰胺治疗晚期乳腺癌疗效较好,不良反应可耐受.     

环磷酰胺联合多西紫杉醇治疗转移性乳腺癌临床观察

目的 观察环磷酰胺联合多西紫杉醇治疗既往接受过多程化疗的转移性乳腺癌患者的近期疗效和毒副反应.方法 26例接受过多程化疗的转移性乳腺癌患者接受环磷酰胺联合多西紫杉醇方案化疗,环磷酰胺:600 mg/m2,d1;多西紫杉醇37.5 mg/m2,d1.8,21 d为1个周期,3个周期后评价疗效和毒副反应.结果 26例患者总...     

多西紫杉醇为主的联合方案治疗晚期乳腺癌的临床观察

目的：观察多西紫杉醇联合顺铂或表阿霉素治疗晚期乳腺癌的疗效及不良反应。方法：晚期乳腺癌患者41例中，26例既往使用蒽环类治疗失败，予多西紫杉醇联合顺铂（TP方案）化疗；15例既往未曾采用葸环类治疗，予多西紫杉醇联合表阿霉索（TE方案）化疗。21天为1周期，2周期后评价疗效，有效者化疗4周期以上。结果：41例中CR5例，PR18例，SD11例，PD7例，总有效率为56．1％（23／41）。不良反应主要为骨髓抑制、脱发、消化道反应，但均可耐受，无化疗相关死亡。结论：多两紫杉醇为主的联合化疗方案治疗晚期乳腺癌疗效较好，不良反应可耐受。     

46例局部晚期乳腺癌的新辅助化疗

目的 观察多西紫杉醇+表阿霉素+环磷酰胺联合(TAC方案)新辅助化疗在局部晚期乳腺癌治疗中的疗效和毒副反应.方法 46例未经治疗的Ⅱb～Ⅲc期的局部晚期乳腺癌(包括炎性乳腺癌)接受TAC方案的新辅助化疗.TAC方案:多西紫杉醇75mg/m2静脉滴注,d1;表阿霉素75 mg/m2静脉注射,d1;环磷酰胺500 mg/m2静脉注射,d1;21 d为1个疗程,共3个疗程.入组患者化疗前均接受肿瘤原发灶空芯针穿刺活检并获得病理组织学确诊.结果 TAC方案新辅助化疗在局部晚期乳腺癌的治疗中总有效率80.4%,其中临床完全缓解15.2%(7/46),临床部分缓解65.2%(30/46),病理完全缓解8.3%(4/46).主要的毒副反应为白细胞减少、脱发和恶心呕吐,发生肺栓塞1例,无败血症和死亡病例.结论 TAC方案新辅助化疗在局部晚期乳腺癌的治疗中疗效显著,耐受性好.     

多西紫杉醇联合卡培他滨治疗晚期乳腺癌的临床观察

目的:观察多西紫杉醇联合卡培他滨治疗晚期乳腺癌的临床疗效及不良反应.方法:38例晚期乳腺癌患者,采用多西紫杉醇75mg/m2,d1;卡培他滨1000mg/m2,bid,d1-14,21天为1个周期.结果:38例乳腺癌患者中,CR 4例,PR 18例,SD 11例,PD 5例,有效率(CR+PR)57.89%.不良反应主要为胃肠道反应、骨髓抑制、脱发、手足综合症.结论:多西紫杉醇联合卡培他滨治疗晚期乳腺癌疗效确切,不良反应可以耐受,可作为晚期乳腺癌的一个较理想方案.     

多西他赛联合表柔比星、环磷酰胺治疗转移性乳腺癌的临床观察

目的：观察多西他赛联合表柔比星、环磷酰胺治疗转移性乳腺癌的临床疗效及不良反应。方法：回顾性分析40例转移性乳腺癌患者的化疗资料,采用国产多西他赛75mg/m2,表柔比星70-90mg/m2静脉滴注,环磷酰胺500mg/m2每3周1次。观察每次化疗后的不良反应,完成4个疗程后观察疗效。结果：全部病例均按计划完成4个周期的化疗。完全缓解（CR）3例,部分缓解（PR）20例,稳定（SD）12例,进展（PD）5例。总有效率（CR＋PR）为57.5%,控制率（CR＋PR＋SD）87.5%。主要不良反应为中性粒细胞减少、恶心、呕吐、腹泻等。结论：多西他赛联合表柔比星、环磷酰胺治疗转移性乳腺癌临床疗效较好,不良反应患者可以耐受。     

三阴性乳腺癌白蛋白结合型紫杉醇与多西他赛新辅助化疗临床对照研究

目的：评价白蛋白结合型紫杉醇、表柔比星联合环磷酰胺对比多西他赛、表柔比星联合环磷酰胺新辅助化疗治疗三阴性乳腺癌的临床效果。方法：将东莞市人民医院2009—01—03—2012—01—31经病理学确诊的三阴性乳腺癌患者42例分为PEC组21例,给予白蛋白结合型紫杉醇260mg／m2,静脉滴入,表柔比星70mg／m2,静脉滴入,环磷酰胺500mg／m2,静脉滴入,3周重复,不做抗过敏预处理;TEC组21例,给予多西他赛75mg／m2,静脉滴入,表柔比星与环磷酰胺应用方法同PEC方案,3周重复,使用多西他赛前1d开始口服地塞米松片7．5mg,2次／d,连服3d。结果：两组患者均完成4个周期新辅助化疗。PEC组RR19例（90．5％）、CR8例（38．1％）、PR 11例（52．4％）、SD2例（9．5％）;TEC组RR18例（85．7％）、CR8例（38．1％）、PR10例（47．6％）和SD3例（14．3％）,两组差异均无统计学意义,P〉0．05;PEC组pCR为28．6％优于TEC组的19．1％,P=0．049。随访截止2013—04—01,中位随访时间25个月（12～48个月）,随访率为100．0％。毒副作用两组中性粒细胞下降、血小板减少、便秘、心脏毒性、肝功能异常、外周神经毒性、肝肾功能异常发生率相比差异均无统计学意义,P〉0．05。结论：白蛋白结合型紫杉醇、表柔比星联合环磷酰胺新辅助治疗局部晚期三阴性乳腺癌疗效显著,毒副作用可耐受,值得进一步研究。     

DC方案与DE方案一线治疗转移性乳腺癌的对比研究

目的　比较多西紫杉醇联合卡培他滨（ＤＣ方案）与多西紫杉醇联合表柔比星（ＤＥ方案）一线治疗转移性乳腺癌的疗效及不良反应。方法　６５例转移性乳腺癌患者分别接受ＤＣ方案和ＤＥ方案治疗。ＤＣ方案组：多西紫杉醇７５ｍｇ／ｍ２静滴,ｄ１;卡培他滨２０００ｍｇ／（ｍ２·ｄ）,分两次口服,ｄ１～ｄ１４。ＤＥ方案组：多西紫杉醇７５ｍｇ／ｍ２静滴,ｄ１;表柔比星７５ｍｇ／ｍ２静推,ｄ１。两方案均以２１天为１个周期。结果　ＤＣ方案组有效率高于ＤＥ方案组（６０.６％ ｖｓ．４６.９％,Ｐ＞０.０５）,其中ＤＣ方案组完全缓解率高于ＤＥ方案组（２４.２％ ｖｓ．６.３％）,两组比较差异有统计学意义（Ｐ＜０.０５）。ＤＣ方案组的６个月后疾病无进展率（ＰＦＲ）优于ＤＥ方案组（７２.７％ ｖｓ．６２.５％,Ｐ＞０.０５）。中位无进展生存期（ＰＦＳ）ＤＣ方案组长于ＤＥ方案组（１１.４个月ｖｓ．７.６个月）,两组比较差异有统计学意义（Ｐ＜０.０５）。不良反应以骨髓抑制、胃肠道反应和脱发为主,３、４级手足综合征发生率ＤＣ方案组（２７.３％,９／３３）高于ＤＥ方案组（０）,差异有统计学意义（Ｐ＜０.０５）。结论　ＤＣ方案及ＤＥ方案一线治疗转移性乳腺癌均取得较好疗效,ＤＣ方案可以作为非蒽环类药物有效的一线治疗方案。     

多西他赛联合表柔比星、环磷酰胺治疗转移性乳腺癌的临床观察

目的:观察多西他赛联合表柔比星、环磷酰胺治疗转移性乳腺癌的临床疗效及不良反应。方法:回顾性分析40例转移性乳腺癌患者的化疗资料,采用国产多西他赛75mg/m2,表柔比星70-90mg/m2静脉滴注,环磷酰胺500mg/m2每3周1次。观察每次化疗后的不良反应,完成4个疗程后观察疗效。结果:全部病例均按计划完成4个周期的化疗。完全缓解(CR)3例,部分缓解(PR)20例,稳定(SD)12例,进展(PD)5例。总有效率(CR+PR)为57.5%,控制率(CR+PR+SD)87.5%。主要不良反应为中性粒细胞减少、恶心、呕吐、腹泻等。结论:多西他赛联合表柔比星、环磷酰胺治疗转移性乳腺癌临床疗效较好,不良反应患者可以耐受。     

Phase I, dose-finding study of capecitabine in combination with docetaxel and epirubicin as first-line chemotherapy for advanced breast cancer.

PURPOSE: Capecitabine is an oral fluoropyrimidine with considerable activity and minimal myelosuppression and alopecia. This phase I study evaluated the addition of capecitabine to epirubicin/docetaxel combination therapy as first-line treatment for advanced breast cancer. PATIENTS AND METHODS: Twenty-three female patients with advanced breast cancer received capecitabine (765-1060 mg/m2 twice daily on days 1-14 of a 3-week treatment cycle) in combination with epirubicin and docetaxel (75 mg/m2 i.v. on day 1). RESULTS: The maximum tolerated dose of capecitabine was 985 mg/m2 and the principal dose-limiting toxicity was febrile neutropenia. No grade 3/4 anemia or thrombocytopenia occurred. There were no grade 4 non-hematological events and grade 3 events other than alopecia were rare. Alopecia occurred in all patients and treatment cycles, and asthenia occurred in all patients and in 84% of treatment cycles. Other frequent adverse events included nausea, vomiting, fever, paresthesia and elevated transaminase levels. An objective response to treatment was observed in 91% (95% confidence interval 72% to 99%) of patients. CONCLUSIONS: The addition of capecitabine to docetaxel/epirubicin combination therapy provides a well-tolerated and active first-line chemotherapy regimen in patients with advanced breast cancer, and merits phase II/III evaluation.     

A phase II study of dose-dense epirubicin plus cyclophosphamide followed by docetaxel plus capecitabine and pegfilgrastim support as preoperative therapy for patients with stage II, IIIA breast cancer.

BACKGROUND: This phase II study was conducted to evaluate tumor response rate and safety profile of dose-dense epirubicin plus cyclophosphamide followed by docetaxel plus capecitabine given preoperatively to patients with stage II or IIIA breast cancer. PATIENTS AND METHODS: Patients underwent four cycles of dose-dense cyclophosphamide 600 mg/m(2) and epirubicin 90 mg/m(2) every 2 weeks followed by two cycles of docetaxel 36 mg/m(2) on days 1, 8, and 15 plus capecitabine 1250 mg/m(2) on days 5-18 every 4 weeks, with prophylactic pegfilgrastim. The primary objective of the study was to determine the incidence of pathologic complete response defined as the absence of invasive or in situ cancer in the breast and the axillary nodes at definitive surgery. RESULTS: Forty-four patients were enrolled in the study and 41 (93%) were assessable for response to chemotherapy. An objective clinical response was observed in 38 (93%) patients. Seven patients (17.1%) exhibited a pathologic complete response. Breast-conserving surgery was carried out in 36 (88%) patients. Grade 3/4 neutropenia occurred in 4.3% of 252 administered chemotherapy cycles. No febrile neutropenia, cardiac toxicity, thrombocytopenia or other serious adverse event was registered. CONCLUSION: The sequential combination of dose-dense epirubicin plus cyclophosphamide followed by docetaxel plus capecitabine is an effective and well-tolerated neo-adjuvant chemotherapy for stage II, IIIA breast cancer.     

An advanced metastatic breast cancer patient successfully treated with combination therapy including docetaxel, doxorubicin and cyclophosphamide (TAC) as salvage therapy

We reported here a case of advanced breast cancer successfully treated with combination therapy including docetaxel, doxorubicin and cyclophosphamide (TAC) as salvage therapy. A 56-year-old male was referred to our hospital for treatment of recurrent metastatic breast cancer. When he was admitted, his general condition was poor due to massive intraperitoneal metastasis. We administered TAC chemotherapy (docetaxel 75 mg/m(2), doxorubicin 50 mg/m(2), and cyclophosphamide 500 mg/m(2), every 3 weeks). During chemotherapy, he showed no major adverse effects except grade 3 neutropenia, which could be easily managed with G-CSF administration. Metastatic lesions almost disappeared after 4 cycles of TAC. TAC therapy was considered to be acceptable as salvage therapy for a metastatic male breast cancer patient.