去甲长春花碱联合阿霉素治疗28例转移性乳腺癌疗效观察

晚期转移性乳腺癌目前尚无较好的方案，我们自1997年3月至1999年6月采用去甲长春花碱（NVB）联合阿霉素治疗28例术后转移性乳腺癌患者，收到较好的疗效，现报告如下。     

以紫杉醇为主的联合化疗方案治疗转移性乳腺癌

目的：评价以紫杉醇为主的联合化疗方案治疗转移性乳腺癌的近期疗效和不良反应。方法：紫杉醇135mg/m^2静脉滴注第一天，根据以往化疗用药选择顺铂30mg/m^2静脉滴注第2天至第4天，同时水化，利尿（TP方案），或给予表阿霉素70mg/m^2分2天静脉注射（TE方案）。21-28天为一周期，治疗2-3周期后评价疗效。结果：全组28例CR1例，PR16例，SD5例，PD6例，总有效率60.7%，初治有效率66.7%，复治有效率57.9%。TE方案有效率60.0%，TP方案有效率61.5%。主要不良反应为骨髓抑制，其次是消化道反应。结论：以紫杉醇为的联合化疗方案和转移性乳腺癌呈现较高疗效，对阿霉素耐药及对铂类抗药的晚期乳腺癌也有很高的疗效。     

紫杉醇联合顺铂治疗阿霉素耐药的晚期乳腺癌

乳腺癌是我国常见的恶性肿瘤之一,在女性恶性肿瘤中占第1位,其发病率有逐年增高趋势.阿霉素是治疗晚期乳腺癌常用的有效化疗药物之一,如出现耐药或达到累积剂量,临床治疗就相对困难.紫杉醇自1987年进入临床以来即受到重视,并广泛用于乳腺癌化疗,无论初治和复治均取得了较好疗效.1999年10月-2001年8月我们用紫杉醇联合顺铂治疗对阿霉素耐药的晚期乳腺癌24例,取得了较好疗效.     

诺维本联合阿霉素一线治疗72例转移性乳腺癌

目的 分析72例接受诺维本加表阿霉素联合化疗方案一线治疗转移性乳腺癌患者的疗效及毒性。方法 72例未经化疗的转移性乳腺癌患者，接受诺维本25mg／m^2每周，静滴d1、d8，表阿霉素静注d1，每3周重复。结果 72例可评价疗效、毒性、生存期，完全缓解12．5％(9／72)，部分缓解65．3％(47／72)，稳定18．1％(13／72)，进展4．2％(3／72)，CR PR77．8％(56／72)。WHO血液血毒性：在360个化疗疗程中，Ⅲ和Ⅳ度粒细胞减少分别是32％和16％，Ⅲ和Ⅳ度非血液血毒性低。中位病变进展时间(TTP)为13个月(1～23月)，中位生存期为25个月(3～34月)。结论 诺维本联合表阿霉素一线治疗转移性乳腺癌疗效高、毒性低。     

含吡喃阿霉素方案治疗转移性乳腺癌

目的研究含吡喃阿霉素（THP）联合方案对转移性乳腺癌的临床疗效及安全性.方法采用5-Fu 500mg/m2,THP 50mg/m2,CTX 500mg/m2.每3周重复,至少2周期,治疗40例转移性乳腺癌.结果总有效率57.5%,其中CR 5例.初治者及复治者有效率分别为73.7%及42.9%.曾接受ADR治疗者有效率41.7%.皮肤软组织、淋巴结转移者有效率为88.2%,肺、肝内脏转移者有效率34.8%.毒副反应主要是粒细胞减少,发生率100%,恶心呕吐常见（52.5%）,脱发（27.5%）及心脏毒性（2.5%）轻微.结论含THP联合方案治疗转移性乳腺癌及复治患者是一种有效的方案.     

白蛋白结合型紫杉醇治疗紫杉类耐药转移性乳腺癌47例

摘 要：［目的］ 探讨白蛋白结合型紫杉醇在传统紫杉类治疗失败的转移性乳腺癌中的近期疗效及安全性。［方法］ 筛选47例传统紫杉类（紫杉醇、多西紫杉醇）治疗失败转移性乳腺癌患者,其中31例行白蛋白结合型紫杉醇单药化疗,12例行白蛋白结合型紫杉醇联合卡培他滨化疗,4例行白蛋白结合型紫杉醇联合曲妥珠单抗方案化疗,观察患者的近期疗效和不良反应。［结果］ 47例患者治疗有效率为14.89%,临床获益率为57.45%,中位PFS 3.9个月。患者主要不良反应为中性粒细胞减少及感觉神经毒性。［结论］ 白蛋白结合型紫杉醇对紫杉类治疗失败的转移性乳腺癌仍具有良好的疗效,不良反应可耐受。     

含吡喃阿霉素方案治疗转移性乳腺癌

目的　研究含吡喃阿霉素 (THP)联合方案对转移移性乳腺癌的临床疗效及其安全性。方法　采用 5 Fu5 0 0mg/m2 ,THP 5 0mg/m2 ,CTX 5 0 0mg/m2 。每 3周重复至少 2周期 ,治疗 40例转移性乳腺癌。结果　总有效率 5 7.5 % ,其中CR5例。初治者及复治者有效率分别为 73 .7%及 42 .9%。曾接受ADR治疗者有效率 41.7%。皮肤软组织、淋巴结转移者有效率为 88.2 % ,肺、肝内脏转移者有效率 3 4 .8%。毒副反应主要是粒细胞减少 ,发生率 10 0 % ,恶心呕吐常见 ( 5 2 .5 % ) ,脱发 ( 2 7.5 % )及心脏毒性 ( 2 .5 % )轻微。结论　含THP联合方案治疗转移性乳腺癌及复治患者是一种有效而低毒副反应的方案。     

多西紫杉醇为主的联合方案治疗转移性乳腺癌

目的:探讨多西紫杉醇为主的联合化疗方案治疗转移性乳腺癌的疗效及毒副反应。方法:49例转移性乳腺癌患者中,22例既往使用蒽环类治疗失败,予多西紫杉醇联合顺铂或希罗达治疗;27例既往未曾采用蒽环类治疗,予多西紫杉醇联合阿霉素治疗。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:49例患者中,治疗后完全缓解(CR)11例,部分缓解(PR)23例,稳定(SD)8例,进展(PD)7例,有效率为69·3%(34/49)。中位疾病进展时间为8·5个月,中位生存时间为18·3个月。主要毒副反应为白细胞减少,其中Ⅲ~Ⅳ度占51·0%。结论:多西紫杉醇为主的联合化疗方案治疗转移性乳腺癌疗效确切,毒性反应可耐受。     

紫杉醇联合化疗转移性乳腺癌15例报告

为了研究紫杉醇对转移性乳腺癌疗效,１９９５年８月１９９７年１２月,我院用紫杉醇联合顺铂治疗转移性乳腺癌１５例,报告如下。临床资料１５例病人均为女性患者,年龄３０～５６岁,中位年龄４６岁。其中单纯癌８例,浸润性导管癌４例,髓样癌２例,部分髓样癌部分粘液腺癌１例。所有病例均为乳腺癌改良根治后转移者。按ＷＨＯ标准临床分期为Ⅳ期,其中肺转移６例,肺转移并锁骨上淋巴结转移２例,肺转移并胸腔积液１例,肺转移并骨转移２例,肺转移并肝转移１例,广泛性骨转移１例。初次化疗１例,转移后接受内分泌治疗、放疗及以阿霉…     

紫杉醇与表阿霉素联合治疗晚期乳腺癌的临床观察

目的：观察紫杉醇联合表阿霉素治疗晚期乳腺癌的临床疗效及不良反应。方法：25例均有组织病理学或细胞学诊断及可评价客观指标。采用紫杉醇175mg／m^2 d1，静脉滴注3小时，用紫杉醇前12小时、6小时分别口服地塞米松20mg，给药前30分钟给予苯海拉明50mg口服及西米替丁300mg静脉滴注。表阿霉素40mg／m^2 d1、d2化疗。2l天为一周期，2个周期评价疗效。结果：CR4例，PR13例，SD5例，PD3例，有效率68．0％。不良反应主要为白细胞减少，Ⅲ度占36．O％，Ⅳ度占28．0％；脱发Ⅱ度占48．0％，Ⅲ度占16．0％；腹泻Ⅱ度占32．0％，Ⅲ度占16．0％。结论：紫杉醇联合表阿霉素治疗晚期乳腺癌有效率较高，不良反应可耐受。     

国产阿霉素联合化疗治疗骨转移肿瘤临床观察

目的评价国产阿霉素联合化疗治疗骨转移肿瘤的效果。方法经病理确诊的恶性肿瘤并经有关检查证实有骨转移60例，随机分为两组。治疗组30例，采用阿霉素（ADM）联合化疗方案；对照组30例，采用非ADM联合化疗方案，21天为一周期，连续用3～4个周期，观察指标包括临床症状和体征，X线片、ECT检查。随访时间4个月～12个月以上。结果治疗组与对照组的总有效率分别为56．7％和33．3％（P＜0．05）。结论国产ADM联合化疗方案可做为骨转移肿瘤的姑息性治疗方案。     

紫杉醇（泰素）治疗耐药性妇科癌症的临床报告

紫杉醇（泰素）治疗５５例耐药性妇科恶性肿瘤，每例均为对顺铂或卡铂在内的多种抗癌药耐药患者，其中半数对５种以上抗癌药耐药，近期疗效，完全缓解７例，部分缓解１７例，有效率为４３．６％。毒副反应主要有白细胞总数和中性粒细胞下降，超过反应有面部潮红，皮疹。脱发占１００％。胃肠反应，神经毒性及心肝肾毒性均不严重。泰素对耐药卵巢癌、输卵管癌、子宫内膜癌，绒癌筹均有一定疗效，是目前治疗耐药妇癌的良好药物。     

羟基喜树碱,5—氟尿嘧啶,阿霉素联合化疗治疗胃癌的临床观察

目的观察羟基喜树碱（HCPT），5一氟尿嘧啶（5－FU）和阿霉素（ADM）联合化疗治疗胃癌的疗效和耐受性。方法42例胃癌患者接受HCPT10mg静滴，第1～5天；5－FU750mg，静滴第1～3天；ADM50mg静滴第1天的联合化疗。每3周为一疗程。结果可评价疗效患者24例，总缓解率41．7％（10／24），完全缓解率（CR）8．3％（3／24），部分缓解率（PR）33．3％（8／24）。可评价毒性患者42例，白细胞减少发生率为88％（3～4度仅4．7％），血红蛋白减少和血小板减少分别为19％和28．5％。脱发为100％。其他毒副反应少见。结论以HCPT为主组成的FAHCPT方案治疗胃癌有一定疗效，且毒性可耐受。     

保留乳房治疗侵袭性乳腺癌

目的：研究中国实行保留民听可行性和这种术式成功开展并推广的可能性。方法：回顾性分析本院２１０例乳腺癌中的Ⅰ、Ⅱ期女性乳腺癌１６８例，其中保乳手术１０例，手术方式为：乳腺象限切除＋术中连续冰冻辅助确定术式，术后处理为放疗及化疗合用；结果：改良根治术与保乳手术在生存率和复发率上无显著差异。结论：随早期乳癌检出率的增多及部分切除乳腺治疗癌手术的完善和术后工作的完备，病人对术后生活质量要求的提高，在我国逐     

Paclitaxel and Mitoxantrone in the Treatment of Metastatic Breast Cancer: A Phase II Trial of the Minnie Pearl Cancer Research Network

Background and rationale: The combination of paclitaxel and doxorubicin is highly active in the treatment of metastatic breast cancer, but is associated with substantial toxicity. In this phase II trial, we evaluated the combination of paclitaxel and mitoxantrone in an attempt to maintain efficacy and improve tolerability of this regimen.

Patients and methods: Sixty-three patients with metastatic breast cancer were treated with paclitaxel 200 mg/m², 1 hr IV infusion, and mitoxantrone 10 mg/m² IV, every 21 days. Responding patients received at least six courses of therapy. Ninety-three percent of patients in this trial were receiving first-line treatment for metastatic breast cancer; 62% of patients had received previous adjuvant chemotherapy, and 26% had received previous doxorubicin.

Results: Objective responses were seen in 24 of 61 evaluable patients (39%). Median response duration was 9 months (range 4-37+ months); actuarial 1-, 2-, and 3-year survivals were 62, 32, and 25%, respectively. The treatment was generally well tolerated; 78% of patients had grade 3 or 4 leukopenia at sometime during their treatment course, but only 14 hospitalizations for neutropenia and fever were necessary (4% of courses). Grade 3 fatigue was experienced by 30% of patients. Cardiotoxicity was not observed.

Conclusions: The combination of paclitaxel and mitoxantrone is active, easily administered, and well tolerated in the treatment of metastatic breast cancer. Its activity appears similar to several other taxane-based combination regimens recently evaluated for the treatment of advanced breast cancer.     

Efficacy and safety of combined trastuzumab and paclitaxel therapy as a second-line treatment in women with metastatic Breast Cancer: A single institutional experience

BACKGROUND: In breast cancer, HER-2 overexpression suggests s poor prognosis. Trastuzumab is a humanized monoclonal antibody with specificity to the HER-2 protein. We evaluated the safety and efficacy of combined trastuzumab and paclitaxel therapy in women with metastatic breast cancer. PATIENTS AND METHODS: Combination chemotherapy was given to patients with HER-2 overexpressing metastatic breast cancer. All patients had previously received one or more chemotherapy treatments. Patients received a loading trastuzumab dose of 4 mg/kg intravenously (i.v.), followed by 2 mg/kg maintenance dose at weekly intervals. A paclitaxel dose of 80 mg/m(2) was administered on the same day as the trastuzumab infusion. RESULTS: A total of 53 patients were examined. Seventy percent received two or more prior chemotherapy treatments for metastatic breast cancer, and 66.0% of patients had two or more metastatic sites. The overall response rate to our approach was 37.7%. Median time to progression was 12.0 months. Grade 3/4 neutropenia was seen in only 11.3% of patients. Peripheral neuropathy occurred in 65.1% of patients after seven treatments, requiring us to change to biweekly paclitaxel administration in 16 patients. Most of them were able to continue the treatment. Other toxicities were mild and tolerable. CONCLUSION: Combined trastuzumab and paclitaxel therapy, administered as second-line or later treatment, produced lasting objective responses and was well tolerated by women with HER-2 overexpressing metastatic breast cancer. A major obstacle to continuing treatment was peripheral neuropathy. However, modifying the interval to every 2 weeks enabled us to continue the treatment. This combination chemotherapy was safely performed in our outpatient clinic.     

Phase II study of gemcitabine plus paclitaxel in metastatic breast cancer patients with prior anthracycline exposure

Chemotherapy provides palliation and modest prolongation of symptom-free survival in metastatic breast cancer. Taxane containing regimens are commonly considered to be among the initials in metastatic setting due to earlier use of anthracyclines in the course of breast cancer. Therefore, we conducted this Phase II study to assess efficacy and safety of gemcitabine plus paclitaxel (GT) combination therapy in anthracycline pretreated metastatic first-line setting. Patients and Methods: The study enrolled 26 women with pathologically confirmed and measurable metastatic breast cancer who were previously treated with anthracycline but no prior chemotherapy for metastatic disease. Twenty six and twenty four patients were eligible for toxicity and efficacy evaluations respectively. Mean age was 47.3 years and median ECOG performance status was 0. Twenty patients (76.9 percent) had visceral metastases, most commonly located in liver and lung. Treatment schedule was as follows: paclitaxel 175 mg/m² was administered intravenously in 3 hours on Day 1 and gemcitabine 1000 mg/m² was administered intravenously in 30 minutes on Day 1 after paclitaxel application, and on Day 8 every 21 days. Results: Objective response rate was 41.7 percent (95 percent CI: 21.9-61.4) with 16.7 percent (95 percent CI: 1.7-31.6 percent) CR, and 25.0 percent (95 percent CI: 7.6-42.3 percent) PR. Median time to progression and overall survival were 9.6 and 14.5 months, respectively. Grade 3-4 toxicity was observed in 34.6 percent (9) patients. Treatment of two patients was discontinued due to toxicity, consisting of Grade 3 hypersensitivity reactions and Grade 4 infections in one patient each. Dose reductions due to myelotoxicity were performed in 4 (15.3 percent) patients. Hematologic toxicities were generally manageable with appropriate dose modifications and supportive care. Conclusion: Gemcitabine and paclitaxel combination regimen is effective and has manageable toxicity profile as first line metastatic setting.     

双侧原发性乳腺癌：附55例临床分析

我院1960年1月至1990年1月间共收治原发性乳腺癌3288例,其中55例为双侧原发性乳腺癌(简称双乳癌),发生率1.7％,同时发生0.8％,异时发生0.9％。其诊断标准应结合临床及病理,治疗原则与单乳癌相似。本组5年生存率:同时发生6O.3％,异时发生44.2％。为了早期诊断作者赞成对侧乳房的选择性活检,而预防性对侧乳房切除不可取。     

紫杉醇联合铂类药物治疗晚期非小细胞肺癌临床研究

目的：评价紫杉醇联合铂类药物对晚期非小细胞肺癌的客观疗效及毒副作用。方法：经病理学证实的晚期非小细胞肺癌40例，采用紫杉醇175mg／m^2静脉滴注，第1天，顺铂60mg／m^2～80mg／m^2，第1天～第3天或卡铂(AUC=5)静脉滴注，第1天，每3周重复，所有患者均接受2周期以上的化疗。结果：可评价疗效的30例，有13例达到PK，有1例达到CK，有效率为46．7％。主要毒副作用为骨髓抑制、恶心呕吐、关节肌肉痛、肝功能损害等。大部分患者为Ⅰ度、Ⅱ度反应，患者耐受良好。结论：紫杉醇联合铂类方案是一种对晚期非小细胞肺癌有效的治疗方案，毒副作用轻，临床使用安全，值得临床进一步研究应用。     

腋淋巴结阴性乳腺癌C－erbB－2癌基因过度表达及其预后意义

本研究采用免疫组化法对１００例腋淋巴结阴性（ＡＮＮ）乳腺癌Ｃ－ｅｒｂＢ－２癌基因的过度表达及其与预后的关系进行回顾性分析。结果显示４２％的ＡＮＮ乳腺癌Ｃ－ｅｒｂＢ－２癌基因过度表达，该癌基因的过度表达与患者年龄（Ｐ＞０．２５）、肿瘤大小（Ｐ＞０．１０）、核分级（Ｐ＞０．０５）、组织学分级（Ｐ＞０．２５）及组织学类型（Ｐ＞０．２５）无关，对ＡＮＮ乳腺癌１０年生存率无显著性影响（Ｐ＞０．１０）。提示Ｃ－ｅｒｂＢ－２癌基因不宜作为ＡＮＮ乳腺癌的预后指标。