希罗达联合多西紫杉醇治疗晚期乳腺癌20例临床观察

目的观察以希罗达为主的联合多西紫杉醇治疗晚期乳腺癌的疗效及毒副反应。方法2004年1月至2006年1月对20例晚期乳腺癌患者,采用希罗达2500mg/m^2,每天分早晚2次餐后30min温开水送服,连用14天,停药7天。多西紫杉醇75mg/m^2加生理盐水100ml第1,8天静脉滴注,在接受多西紫杉醇治疗之前进行预处理,在用药前日晚21时及次日5时口服地塞米松7.5mg,连服3天,21天为1个周期。治疗2～4个周期后评价疗效及不良反应。结果20例患者中8例接受了2个周期化疗,12例完成4个周期的化疗。完全缓解（CR）,2例（10%）部分缓解（PR）,7例（35%）好转（MR）,4例（20%）稳定（SD）,2例（10%）进展（PD）,5例（25%）总有效率（RR）,（CR＋PR）45%。最常见的不良反应为胃肠道反应、骨髓抑制、手足综合症、皮肤色素沉着、少数乏力等。Ⅲ度不良反应仅见于少数病例,其中中性粒细胞减少5例、手足综合症2例。结论希罗达联合多西紫杉醇作为二线方案治疗晚期乳腺癌的疗效确切,显著延长疾病进展时间,提高生存率,而且不良反应轻,有望成为紫杉类或蒽环类药物治疗失败的晚期乳腺癌的理想方案。

Clinical Observation of 20 Patients with Advanced Breast Cancer Treated with Xeloda and Docetaxel

Objective To study the efficacy and toxicities of Xeloda combined with Docetaxel in treating 20 patients with advanced breast cancer.Methods From January,2004 to January,2006,20 patients with advanced breast cancer were treated with Xeloda combined with Docetaxel.Xeloda was given 2 500 mg/m2 twice a day for 14 days,and Docetaxel was given 75 mg/m2 intravenously during the 1st and 8th day.The chemotherapy repeated every 3 weeks.Efficacy and toxicities were reviewed after 2 to 4 cycles of chemotherapy.Results 8 of 20 patients received 2 cycles of chemotherapy,and 12 patients received 4 cycles.2 patients achieved CR and 7 patients achieved PR.The tumor was evaluated as MR in 4 cases,SD in 2 cases and PD in 5 cases.The response rate (RR,CR plus PR) was 45%.Most common toxicities were gastrointestinal toxicities,myelosuppression,hand-foot syndrome,cutaneous pigmentation and fatigue etc.Serious toxicities were uncommon,including granulocytopenia in 5 cases and hand-foot syndrome in 2 cases.Conclusion Xeloda combined with Docetaxel as second-line chemotherapy was effective in treating advanced breast cancer.The overall survival and disease free time is significantly prolonged.Toxicities were mild and acceptable.This regime could be used in the patients after failure from treatment by Taxol and anthracycline.