紫杉特尔治疗转移性乳腺癌的临床疗效

背景与目的：近年来,采用大剂量紫杉特尔（Taxotere,TXT)治疗转移性乳腺癌已证明其有高度抗肿瘤活性。而用中等剂量TXT及阿霉素治疗该肿瘤却极道甚少。本研究观察及评价TXT单药及TXT联合阿霉素治疗术后转移性乳腺癌的疗效和不良反应。方法：自1996年9月至2000年4月我科共收治34例转移性乳腺癌患者并随机分成两组,A组14例用TXT单药75mg/m^2静脉滴注1h治疗;B组20例用TXT60mg/m^2联合阿霉素50mg/m^2静脉滴注,两组均以21天为1个疗程,完成3个疗程的化疗后进行近期疗效评价。结果：A,B组近期有效率分别为57．14％（8／14）及75．00％（15／20）;2年生存率分别为35．7％（5／14）及40．0％（8／20）;4年总生存率分别为14．3％（2／14）和15．0（3／20）;中位总生存期分别为22个月及23个月;中位总缓解期分别为10个月及11个月,两组主要不良反应有骨须抑制,恶心,呕吐,口腔炎、腹泻,脱发,乏力,肌肉痛及轻度体液潴留和皮肤潮红,A、B组Ⅲ/Ⅳ度白细胞减少发生率分别为57．1％（8／14）及70．0％（14／20）,结论：TXT是对转移性乳腺癌有较好疗效的药物,主要剂量限制性不良反应为骨髓抑制,但多能自行恢复且患者可耐受。

Clinical research of taxotere in treatment of metastatic breast cancer

BACKGROUND & OBJECTIVE: Recently, high-dose docetaxel has been proved to be an effective antineoplastic drug in the treatment of metastatic breast cancer.However,there was a few reports about moderate-dose docetaxel and Adriamycin in the treatment of metastatic breast cancer. This study was designed to observe the response rate and toxic reaction of Taxotere and Taxotere plus Adriamycin in the treatment of metastatic breast cancer. METHODS: From September 1996 to April 2000, 34 cases with metastatic breast cancer, which were treated in Department of Oncology, The Second Central Hospital in Tianjin, were included in the study. For group A (14 cases), Taxotere single agent was administered at a dose of 75 mg/m(2) iv 1 hour. For group B, Taxotere was administered at a dose of 60 mg/m(2) combined with Adriamycin 50 mg/m(2) i.v. 1 hour. The same schedule for both groups was repeated every 21 days, with three cycles for all patients. RESULTS: The recent response rates of group A and group B were 57.14% (8/14) and 75.0% (15/20), respectively. The 2-and 4-year survival rates were 35.7%, 14.3% for group A, and 40.0%, 15.0% for group B. The median overall survival durations of group A and group B were 22 months and 23 months. The median overall response durations of these two groups were 10 and 11 months, respectively. The main adverse reactions of these two groups were neutropenia, nausea, vomiting, stomatitis, diarrhea, alopecia, fatigue, myalgia, fluid retention, and skin flushing. Grade 3 and grade 4 neutropenia occurred in group A and group B were 57.1% (8/14) and 70.0% (14/20), respectively. CONCLUSION: Taxotere is effective in the treatment of metastatic breast cancer. The toxic reactions are tolerable.