乳腺癌术后化疗相关的情景记忆损害的特征分析

目的 探讨乳腺癌术后化疗相关认知障碍（CICI）患者的情景记忆损害的特征。方法收集本院2012年1月至2014年2月收治的40例女性乳腺癌患者,均给予6个周期的术后辅助化疗,分别于化疗前后采用简易精神状态量表（MMSE）、词汇流畅性测试（VFT）和数字广度（DS）评价其神经心理学背景情况,采用源记忆与项目记忆的神经心理学测验方法测试化疗前后的源记忆与项目记忆情况。结果40例患者化疗前后的MMSE、VFT和DS评分的差异均无统计学意义（P＞0.05）;且化疗前后的项目记忆成绩分别为（0.69±0.06）分和（0.66±0.08）分,差异无统计学意义（P＞0.05）;但其化疗后的源记忆成绩为（0.51±0.08）分,低于化疗前的（0.70±0.06）分,差异有统计学意义（P＜0.05）。结论乳腺癌CICI患者存在情景记忆损害,主要表现为源记忆的损害,而项目记忆却相对保留。     

乳腺癌化疗相关认知障碍的前瞻性记忆损害的特征

目的 探讨乳腺癌患者出现化疗相关认知障碍（CICI）中基于事件的前瞻性记忆（EBPM）和基于时间的前瞻性记忆（TBPM）损害的特征。方法 分别建立EBPM和TBPM的神经心理学测验方法,选取27例乳腺癌术后辅助化疗患者（观察组）以及年龄、教育程度相匹配的30例健康者（对照组）进行测试,记录两组数据并比较。结果观察组的EBPM得分为1.11±1.09,明显低于对照组的2.23±0.77（P＜0.01）;观察组和对照组的TBPM得分分别为4.33±1.24和4.83±1.09,差异无统计学意义（P＞0.05）。结论 乳腺癌患者出现CICI中存在前瞻性记忆损害,主要表现为EBPM损害,而TBPM损害不明显。     

Phase II study of a new vinca alkaloid derivative,S12363, in advanced breast cancer

Vinca alkaloids are widely used in the medical treatment of breast cancer. Our study aimed to evaluate the therapeutic activity of a new vinca alkaloid derivative, S12363 (vinfosiltine), which is 36 and 72 times more cytotoxic in vitro than vincristine and vinblastine, respectively. Because phase I studies did not allow a choice of the best treatment schedule, a randomization was performed between two schedules with the same dose intensity, that is, 0.3 mg/m² given weekly or 0.6 mg/m² given every 2 weeks. A total of 16 patients with advanced breast cancer who had failed a first-line treatment without any vinca alkaloid were entered in the study. Additionally, 6 women received the bimonthly regimen as first-line treatment of advanced breast cancer. Altogether, 17 patients received, prior to vinfosiltine, an anthracycline-based regimen given either as adjuvant (n=4) or as first-line palliative treatment (n=13). All 22 patients were evaluable for both toxicity and response. Neutropenia was the main toxic event (maximal toxicity per patient) with grade 3 (WHO) toxicity developing in 7/22 patients and grade 4, in 8/22. Other severe toxicities included leukopenia (n=9), anemia (n=1), diarrhea (n=1), constipation (n=1), and fatigue (n=1). No patient achieved a complete or partial response. Vinfosiltine does not appear to have significant single-agent activity in advanced breast cancer at the doses and the schedules used in our study.     

Pulmonary changes after radiotherapy for conservative treatment of breast cancer: a prospective study

PURPOSE: Radiotherapy (RT) after conservative surgery for breast cancer involves part of the pulmonary parenchyma with a potential detrimental effect of reducing the normal functional reserve. Such an effect deserves to be studied in depth, considering the given long life expectancy of these women. We prospectively analyzed high-resolution computed tomography (HRCT) and pulmonary function tests (PFTs) with correlation with dosimetric data from RT. METHODS AND MATERIALS: Lung HRCT and PFTs were performed in 41 women who had undergone conservative surgery for breast cancer before and 3 and 9 months after postoperative RT. The PFTs included forced vital capacity, forced expiratory volume in 1 s, total lung capacity, maximal expiratory flow at 50% and 25% of vital capacity, and the diffusion capacity of carbon monoxide. HRCT was matched with the RT treatment plan images to analyze the dosimetric correlation. RESULTS: At 3 months after RT, the lung alterations were classified at HRCT as follows: 46.3% were Grade 1, 24.4% Grade 2, and 7.3% Grade 3, and at 9 months, 58.5% were Grade 1, 19.5% Grade 2, and 0% Grade 3. The PFTs showed a significant decrease at 3 months, with only partial recovery at 9 months. Chemotherapy, but not hormonal therapy, was associated with PFT changes. The grade of fibrosis increased with increasing lung volume treated to a dose > or = 25 Gy. CONCLUSION: Lung changes, mainly related to damage to the alveolar-capillary barrier and smallest airway ramifications, were observed at 3 months, with only partial recovery at 9 months after RT. Minimizing the lung volume receiving > or = 25 Gy could reduce pulmonary toxicity.     

Risk for endometrial cancer following breast cancer: a prospective study in Sweden

The risk for endometrial cancer among women with breast cancer might increase following use of tamoxifen, recently classified as a carcinogen of the human endometrium. However, the strength of the association remains uncertain and it is unknown whether use of this drug - widely prescribed in Sweden since the mid-1980s - has had any measurable effect at the population level. We analyzed all cases of breast cancer (n = 131,614) detected in the nationwide Swedish Cancer Registry in 1958-93. Incident cases of endometrial cancer during follow-up were identified also through the Cancer Registry. Standardized incidence ratios (SIR) and their 95 percent confidence intervals(CI) were computed by use of nationwide rates of endometrial cancer, adjusted for age and calendar year. During follow-up of up to 35 years of the breast cancer cohort, 803 incident endometrial cancers were identified, yielding an overall SIR of 1.58 (CI = 1.47-1.70). In univariate analyses, there was no increase in SIR in recent years. However, the excess risk increased linearly with increasing age at breast cancer diagnosis (P trend < 0.0001) and decreased markedly with longer follow-up (P trend < 0.0001). A multivariate regression analysis, with adjustment for age and year of follow-up, revealed no increased risk for subsequent endometrial cancer among breast cancer cases diagnosed more recently (P trend = 0.19); compared with the period 1958-63,the risk estimate in the last time period (1989-93) was 0.72 (CI =0.51-1.01). We conclude that the risk for endometrial cancer following breast cancer has not increased over time in Sweden. This revised version was published online in July 2006 with corrections to the Cover Date.     

吉西他滨对复发性乳腺癌患者的化疗作用

 目的 探讨吉西他滨在乳腺癌化疗中的作用。方法 取得不同患者的乳腺癌组织标本，采用胶原酶消化法获取乳腺癌原代细胞，应用原代培养和MTT法检测各种化疗药物在体外对乳腺癌原代细胞的杀伤效果。结果 对原发性乳腺癌患者，紫杉类药物的疗效优于蒽环类药物和吉西他滨（P＜0.01）；对复发性乳腺癌患者，吉西他滨的疗效则明显优于蒽环类和紫杉类药物（P＜0.01）。结论 吉西他滨可以作为乳腺癌化疗的二线药物应用于复发性患者。     

Cirrhosis-like radiological pattern in patients with breast cancer

INTRODUCTION: Hepatic toxicity of breast cancer therapy is well known, usually consisting of elevation in the serum levels of hepatic enzymes or fatty infiltration of the liver. The chemotherapeutic agents most commonly linked to hepatotoxic effects are methotrexate, anthracyclines, taxanes and cyclophosphamide. There are few reports of patients with liver metastasis having radiological findings mimicking cirrhosis, both in the presence or the absence of prior systemic chemotherapy. Hepatotoxicity of antineoplastic drugs and cellular necrosis induced by response of liver metastases to chemotherapy may play a critical role in its physiopathology. MATERIALS AND METHODS: This article reports a series of ten women with breast cancer (nine with liver metastasis) treated with chemotherapy or hormonotherapy. RESULTS: They had low risk factors for hepatic disease, but developed a cirrhosis-like appearance in the computed tomography scan. The patient without liver metastasis is the second of this kind described in the literature. Relatively few reports have documented clinical sequelae of portal hypertension. In our series, three patients had oesophageal bleeding varices needing be hospitalised. To our knowledge, these are the first cases reported in the literature. CONCLUSIONS: This suggests that some manifestations of portal hypertension may develop in association with the cirrhosis- like pattern induced by breast cancer therapy.     

Perception, attitudes, preparedness and experience of chemotherapy-induced alopecia among breast cancer patients: a qualitative study

Objectives: Regardless of its negative impact on quality of life, little is known about the importance ofalopecia from the patients’ perspective. This study aimed to explore the whole experience of chemotherapyinducedalopecia among Korean breast cancer patients including perception, attitudes, preparedness,and changes after alopecia. Methods: Patients expected to experience or had experienced alopecia wererecruited at a tertiary hospital in Seoul, Korea. Semi-structured in-depth interviews were performed in 21patients. Recurrent issues were identified and placed into thematic categories. Results: All patients thinkthat appearance is important and they pay attention to how they look like. They had negative perceptionsabout alopecia. Patients were not well prepared for alopecia, and experienced substantial physical,psychological and social distress. Lack of information and limited social support combined with negativeimages of cancer made it difficult for patients to overcome the trauma and deterred them from usual dailyactivities resulting in poor quality of life. Conclusions: Patients were not well prepared for alopecia andnegative perceptions, lack of preparedness, and limited social support and resources increased alopeciarelateddistress. Educational programs for preparing patients to cope with alopecia distress and advocateactivities to change people’s negative perception about alopecia are needed to reduce the burden imposedby alopecia in cancer patients.     

A phase III randomized study on the sequencing of radiotherapy and chemotherapy in the conservative management of early-stage breast cancer

PURPOSE: To compare two different timings of radiation treatment in patients with breast cancer who underwent conservative surgery and were candidates to receive adjuvant cyclophosphamide, methotrexate, and fluorouracil (CMF) chemotherapy. METHODS AND MATERIALS: A total of 206 patients who had quadrantectomy and axillary dissection for breast cancer and were planned to receive adjuvant CMF chemotherapy were randomized to concurrent or sequential radiotherapy. Radiotherapy was delivered only to the whole breast through tangential fields to a dose of 50 Gy in 20 fractions over 4 weeks, followed by an electron boost of 10-15 Gy in 4-6 fractions to the tumor bed. RESULTS: No differences in 5-year breast recurrence-free, metastasis-free, disease-free, and overall survival were observed in the two treatment groups. All patients completed the planned radiotherapy. No evidence of an increased risk of toxicity was observed between the two arms. No difference in radiotherapy and in the chemotherapy dose intensity was observed in the two groups. CONCLUSIONS: In patients with negative surgical margins receiving adjuvant chemotherapy, radiotherapy can be delayed to up to 7 months. Concurrent administration of CMF chemotherapy and radiotherapy is safe and might be reserved for patients at high risk of local recurrence, such as those with positive surgical margins or larger tumor diameters.     

吉西他滨联合长春瑞滨治疗晚期三阴性乳腺癌的临床观察

目的：观察吉西他滨联合长春瑞滨（ＧＮ方案）治疗ＥＲ、ＰＲ、ＨＥＲ ２均阴性（三阴性）晚期转移性乳腺癌的疗效与安全性。方法：２００４年１月～２００８年１月共３７例经免疫组化证实ＥＲ、ＰＲ、ＨＥＲ ２均阴性的晚期转移性乳腺癌复治患者参与研究。患者接受吉西他滨联合长春瑞滨方案治疗：吉西他滨１ ０００ｍｇ／ｍ２,静脉滴注３０ｍｉｎ,ｄ_１、ｄ_８;长春瑞滨２５ｍｇ／ｍ^２静脉滴注１５ｍｉｎ,ｄ_１、ｄ_８。２１天重复。结果：全组３７例共完成１３６个周期的治疗,中位数４个周期,范围２～６个周期,均可评价疗效。完全缓解１例（２.７％）,部分缓解８例（２１.６％）,病情稳定２０例（５１.４％）,病情进展９例（２１.６％）,客观有效率为２４.３％;中位疾病进展时间（ｍＴＴＰ）６个月（９５％ ＣＩ：４～８个月）,中位生存期（ＯＳ）２４个月（９５％ ＣＩ：１１～３７个月）,１年生存率为（６６.２４±８.４３）％,３年生存率为（２８.７７±１１.９６）％。毒副反应主要为Ⅰ ～Ⅱ度骨髓抑制、末梢神经毒性、胃肠道反应、流感样症状、轻度肝功能损伤等。结论：吉西他滨联合长春瑞滨治疗晚期三阴性乳腺癌患者,初步观察有一定的疗效,其毒副作用患者可以耐受。     

Changes in pulmonary function after incidental lung irradiation for breast cancer: A prospective study

PURPOSE: The aim of this study was to analyze changes in pulmonary function after radiation therapy (RT) for breast cancer. METHODS AND MATERIALS: A total of 39 consecutive eligible women, who underwent postoperative irradiation for breast cancer, were entered in the study. Spirometry consisting of forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1), carbon monoxide diffusing capacity (DLCO), and gammagraphic (ventilation and perfusion) pulmonary function tests (PFT) were performed before RT and 6, 12, and 36 months afterwards. Dose-volume and perfusion-weighted parameters were obtained from 3D dose planning: Percentage of lung volume receiving more than a threshold dose (Vi) and between 2 dose levels (V(i-j)). The impact of clinical and dosimetric parameters on PFT changes (Delta PFT) after RT was evaluated by Pearson correlation coefficients and stepwise lineal regression analysis. RESULTS: No significant differences on mean PFT basal values (before RT) with respect to age, smoking, or previous chemotherapy (CT) were found. All the PFT decreased at 6 to 12 months. Furthermore FVC, FEV(1), and ventilation recovered almost to their previous values, whereas DLCO and perfusion continued to decrease until 36 months (-3.3% and -6.6%, respectively). Perfusion-weighted and interval-scaled dose-volume parameters (pV(i-j)) showed better correlation with Delta PFT (only Delta perfusion reached statistically significance at 36 months). Multivariate analysis showed a significant relation between pV(10-20) and Delta perfusion at 3 years, with a multiple correlation coefficient of 0.48. There were no significant differences related to age, previous chemotherapy, concurrent tamoxifen and smoking, although a tendency toward more perfusion reduction in older and nonsmoker patients was seen. CONCLUSIONS: Changes in FVC, FEV1 and ventilation were reversible, but not the perfusion and DLCO. We have not found a conclusive mathematical predictive model, provided that the best model only explained 48% of the variability. We suggest the use of dose-perfused volume and interval-scaled parameters (i.e., pV(10-20)) for further studies.     

Epirubicin or epirubicin and cisplatin as first-line therapy in advanced breast cancer. A phase III study

Purpose: To compare the efficacy and toxicity of epirubicin to that of the combination of epirubicin and cisplatin in patients with advanced breast cancer. Patients and methods: A total of 155 patients were randomized to receive either epirubicin (70 mg/m²) days 1 and 8 every 4 weeks or epirubicin (60 mg/m²) days 1 and 8 plus cisplatin (100 mg/m²) day 1 every 4 weeks. Epirubicin was continued until disease progression or to a cumulative dose of 1000 mg/m². Cisplatin was discontinued after six cycles. In 45 premenopausal women an oophorectomy was performed. None of the evaluable patients had received chemotherapy for metastatic disease. Results: Among evaluable patients (74 in the epirubicin group and 65 in the epirubicin plus cisplatin group) there were 19% vs 29% complete responses, and 42% vs 37% partial responses, with no significant difference. In the epirubicin plus cisplatin group the response rate was significantly higher in previously untreated patients as compared with patients who had received adjuvant chemotherapy (74% vs 55%, P=0.002). Median times to disease progression were 8.4 months in the epirubicin group and 15.3 months in the epirubicin plus cisplatin group (P=0.045). Median survival times were 15.1 and 21.5 months, respectively (P=0.41). In the epirubicin plus cisplatin group leukopenia and thrombocytopenia were significantly more frequent, 29% of the patients developed mild to moderate peripheral neurotoxicity, 34% reported tinnitus and hearing changes, 6 patients developed nephrotoxicity (one died due to nephrotic syndrome), and 3 patients developed leukaemia (two died of this cause). Congestive heart failure occurred in six patients in the epirubicin group and three patients in the epirubicin plus cisplatin group. Conclusion: Cisplatin plus epirubicin is an active, although highly toxic regimen when used as first-line therapy in advanced breast cancer. The time to disease progression was significantly longer in the cisplatin plus epirubicin group (increased by 82%). Due to toxicity, the combination regimen cannot be recommended. However, the study indicated a very high activity of cisplatin in advanced breast cancer. Studies of first-line therapy in advanced breast cancer including cisplatin or other platin derivatives in combination with, for example, the taxanes are suggested. Received: 8 December 1999 / Accepted: 17 July 2000     

Vinorelbine in the management of breast cancer: New perspectives, revived role in the era of targeted therapy

Vinorelbine is a semi-synthetic vinca alkaloid that has been shown active in many tumour types and is currently registered for the treatment of advanced breast cancer (ABC) and non-small cell lung cancer (NSCLC). This agent has a generally favourable safety profile, and may be suitable for use in special populations such as the elderly and/or frail patient. However, with the taxanes firmly established as standard second line treatment for ABC after failure of an anthracycline, vinorelbine has been generally relegated for use as third line therapy, in competition with the oral compound capecitabine. More recently, the exciting results observed with the combination of vinorelbine and trastuzumab in patients with Her-2 overexpressing/amplified tumours, as well as the development of a reliable formulation and revised schedule of oral vinorelbine with proven activity in ABC appear to have revived the interest in this compound in the management of this disease. There are still a number of unanswered questions that will have to be addressed by properly designed, adequately powered randomised clinical trials.     

A prospective study comparing digital breast tomosynthesis with digital mammography in surveillance after breast cancer treatment

BackgroundAlthough the benefit of adjunct digital breast tomosynthesis (DBT) is established in population screening, its benefit in surveillance after breast cancer treatment is not well defined. We prospectively evaluated whether the addition of DBT to digital mammography (DM) reduced the rate of indeterminate findings compared to DM alone in patients after breast cancer treatment.MethodsPatients had both DM and DBT for routine surveillance. Two-dimensional synthesised mammogram (SM) was generated for each patient from DBT data. DM, SM, and DBT images were read for each patient by one of four radiologists credentialed for DBT. We compared the rates of indeterminate findings between DM + DBT with DM alone in patients with a range of breast densities and between DM and SM.ResultsA total of 618 patients and 1069 breasts were analysed. The rates of indeterminate findings for DM + DBT versus DM alone were 10.5% and 13.1%, respectively (p = 0.018). In breasts treated with surgery and radiotherapy (n = 558), the corresponding rates of indeterminate findings were 4.9% and 6.9%, respectively (p = 0.039). The rate of indeterminate findings for DM + DBT increased with increasing breast density (p = 0.019). There was no significant difference in the rates of indeterminate findings between DM and SM (13.1% versus 11.5%, p = 0.1).ConclusionThe addition of DBT to DM reduced the rate of indeterminate findings in surveillance of patients after breast cancer treatment. Further research is required to confirm whether DBT and SM could replace DM for patients undergoing surveillance.     

Adjuvant chemotherapy and radiotherapy in triple-negative breast carcinoma: A prospective randomized controlled multi-center trial

Background and purpose: Triple-negative breast cancer (TNBC) presents a high risk breast cancer that lacks the benefit from hormone treatment, chemotherapy is the main strategy even though it exists in poor prognosis. Use of adjuvant radiation therapy, which significantly decreases breast cancer mortality, has not been well described among poor TNBC women. The aim of this study was to evaluate whether the combination of chemotherapy and radiotherapy could significantly increase survival outcomes in TNBC women after mastectomy. Patients and methods: A prospective randomized controlled multi-center study was performed between February 2001 and February 2006 and comprised 681 women with triple-negative stage I–II breast cancer received mastectomy, of them, 315 cases received systemic chemotherapy alone, 366 patients received radiation after the course of chemotherapy. Recurrence-free survival (RFS) and overall survival (OS) were estimated. Simultaneously local and systemic toxicity were observed. Results: After a median follow-up of 86.5 months, five-year RFS rates were 88.3% and 74.6% for adjuvant chemotherapy plus radiation and adjuvant chemotherapy alone, respectively, with significant difference between the two groups (HR 0.77 [95% CI 0.72, 0.98]; P = 0.02). Five-year OS significantly improved in adjuvant chemotherapy plus radiation group compared with chemotherapy alone (90.4% and 78.7%) (HR 0.79 [95% CI 0.74, 0.97]; P = 0.03). No severe toxicity was reported. Conclusions: Patients received standard adjuvant chemotherapy plus radiation therapy was more effective than chemotherapy alone in women with triple-negative early-stage breast cancer after mastectomy.     

Current progress in the prediction of chemosensitivity for breast cancer

Advances in chemotherapy have improved the prognosis of patients with breast cancer significantly. Individualization is important for optimization of chemotherapy. The prediction of tumor sensitivity to anticancer agents has been intensively investigated for that purpose. There have been 2 approaches to predict the efficacy of drugs against individual tumors, drug-sensitivity tests and molecular marker genes. Although some of these tests are already available clinically, the prediction of chemosensitivity remains a goal to be achieved. Several studies with microarrays revealed that comprehensive analyses of genes may provide useful information for determining the chemosensitivity of cancer. We have started to use a cDNA microarray to study the chemosensitivity of breast cancer. Taken together with recent data, studies for drug sensitivity should provide insights into the mechanisms of drug sensitivity and the optimal design of more effective treatment strategies in breast cancer.     

含洛铂的联合方案治疗晚期乳腺癌的临床观察

目的 观察含洛铂的联合化疗方案治疗晚期复治乳腺癌的疗效及毒副反应。方法 收集2010年1月至2012年5月47例治疗后进展的晚期乳腺癌患者,给予含洛铂（30mg／m²）的联合化疗方案,3～4周为1个周期。至少化疗2个周期后评价疗效及毒副反应。结果 全组47例患者均可评价疗效和毒副反应。无1例获CR,PR 13例,SD 22例,PD 12例,有效率（RR）为27.7％,疾病控制率（DCR）为74.5％。ER或HER-2阳性表达者与其阴性表达者DCR比较,差异均无统计学意义（P＞0.05）。二线治疗者与三线及以上治疗者的RR比较,差异亦无统计学意义（P＞0.05）。至随访截止日期,36例疾病进展,中位疾病进展时间（TTP）为4.7个月（95％CI：4.1～5.3个月）。主要毒副反应为骨髓抑制、消化道反应及疲乏等,多为1、2级,经对症处理后均能缓解,无治疗相关性死亡。结论 含洛铂的联合方案治疗晚期复治乳腺癌疗效较好,毒副反应可耐受。     

乳腺癌术后同步放化疗的急性期反应观察

目的观察乳腺癌根治术后行同步放化疗的急性期反应.方法 24例乳腺癌患者根治术后给予CAF或TE方案化疗,同时行放疗.胸壁、锁骨上区剂量DT50 Gy,DT2 Gy/次,5次/周.结果 3例发生3度皮肤反应,中断放疗5天,1例TE方案患者因出现严重四肢末梢神经炎症,而改用CAF方案,无1例放射性肺炎发生.结论乳腺癌患者根治术后,可以耐受放疗联合CAF/TE方案化疗.放化疗最佳时间选择,远期疗效及晚期毒性反应尚须进一步研究.     

多西他赛联合卡培他滨治疗复发转移乳腺癌的疗效及相关因素研究

目的　探讨低剂量多西他赛联合卡培他滨治疗复发转移乳腺癌的疗效及其预测因素。方法　２００６年６月至２００９年１２月收治３８例复发转移乳腺癌女性患者给予多西他赛联合卡培他滨治疗,具体方案为：多西他赛６０ｍｇ／ｍ２静滴,ｄ１;卡培他滨９５０ｍｇ／ｍ２口服,每日２次,ｄ１～ｄ１４;２１天为１周期。２个周期评价疗效,并随访无进展生存时间（ＰＦＳ）。选取ＰＳ评分、绝经状态、ＥＲ、ＨＥＲ ２、转移数目、既往化疗共６个指标分别建立两分类Ｌｏｇｉｓｔｉｃ回归模型和Ｃｏｘ风险比例模型,分析上述指标对疗效的预测情况。结果　３８例患者均接受２～６个周期化疗,获ＣＲ３例,ＰＲ１８例,ＳＤ１０例,ＰＤ７例,有效率（ＲＲ）为５５.３％（２１／３８）;中位ＰＦＳ为７.１个月（９５％ＣＩ：４.８～９.６个月）。主要毒副反应为恶心呕吐、乏力、白细胞减少和手足综合征等,其中３～４级白细胞减少为１５.８％。６个指标中ＰＳ评分（Ｐ＝０.００３）、绝经状态（Ｐ＝０.０４３）和转移数目（Ｐ＝０.０２１）均与ＲＲ有关,仅ＰＳ评分为ＲＲ的独立预测因素（Ｐ＜０.０５）;Ｃｏｘ风险比例模型显示,ＰＳ评分是ＰＦＳ的独立预测因素（Ｐ＜０.０５）。结论　低剂量多西他赛联合卡培他滨治疗复发转移乳腺癌的疗效好,安全性高;ＰＳ评分可以作为该方案疗效预测的独立因素。