吉西他滨联合顺铂治疗多药耐药的晚期乳腺癌的临床观察

目的观察吉西他滨联合顺铂方案治疗蒽环类及紫杉类耐药晚期乳腺癌的疗效与安全性。方法2007年1月～2008年4月以吉西他滨联合顺铂方案治疗蒽环类及紫杉类耐药晚期乳腺癌15例,吉西他滨1000 mg.m-2静滴,第1、8天,顺铂25 mg.m-2,静脉滴注,第1～3天;每21 d为一周期,至少治疗2周期。结果全组患者均可评价疗效,其中完全缓解（CR）1例（6.7%）,部分缓解（PR）6例（40.0%）,稳定（SD）5例（33.3%）,进展（PD）3例（20.0%）,总有效率（ORR）46.7%,TTP6.4月,MST13.2月;Ⅲ～Ⅳ度毒性反应分别为血小板减少20.0%,白细胞减少26.7%,恶心或呕吐13.3%。结论吉西他滨和顺铂联合方案治疗蒽环类及紫杉类耐药晚期乳腺癌的疗效较好,使用方便,毒性反应较轻,是蒽环类及紫杉类耐药晚期乳腺癌的有效解救治疗方案。

Gemcitabine plus cisplatin for the treatment of multi-medicine resistant advanced breast cancer

Aim To evaluate the efficacy and safety of combination chemotherapy of gemcitabine and cisplatin for anthracycine or taxanes resistant advanced breast cancer.Methods From January 2007 to April 2008,15 patients with anthracycine or taxanes resistant advanced breast cancer were treated with combination chemotherapy of gemcitabine and cisplatin,gemcitabine administered 1000 mg·m-2 on day 1 and 8 cisplatin 25 mg·m-2 on day 1 to 3,which was recycled every 21 days and at least 2 cycles.Result Of all 15 patients qualified for efficacy analysis, an objective response was obtained in 46.7%. 1 patient achieved complete responses （6.7%） 6 partial responses （40.0%） ,5 stable disease （33.3%） and 3 progressive disease（ 18.6% ）. TFP was 6.4 months, MST 13.2 months. The main toxicities （ grade Ⅲ-Ⅳ） were thrombocytopenia （20.0%）, hypoleucocytosis （26.7 % ）, and nausea/vomiting （ 13.3 % ）. Conclusion The combination chemotherapy of gemcitabine and cisplatin is active in anthracycine or taxanes resistant advanced breast cancer with an acceptable toxicity pattern and may well represent an interesting therapeutic choice after anthracycine or taxanes resistant.