HEP方案与NP方案治疗难治性晚期乳腺癌的临床观察

目的:观察比较含羟基喜树碱(HCPT)的HEP方案与含长春瑞滨(NVB)的NP方案治疗多次化疗失败的晚期乳腺癌患者的有效性和安全性。方法:经病理学检查证实,治疗复发或转移后经至少一种化疗方案治疗失败的同期晚期乳腺癌患者53例,分为HEP组和NP组。HEP组23例采用HCPT6mg/m2静脉滴注,d1~d5,足叶乙甙(VP-16)100mg静脉滴注,d1~d5,顺铂(PDD)20mg静脉滴注,d1~d5。NP组30例采用长春瑞滨(NVB)25mg/m2,静脉滴注d1、d5,顺铂(PDD)20mg静脉滴注,d1~d5。均为4周重复,治疗2~4个周期。2个周期治疗结束后按照WHO标准评价疗效和毒性。结果:HEP组近期有效率为17.4%(4/23),其中CR0例,PR4例(17.4%),NC14例(60.9%),PD5例(21.4%),RR为17.4%,DCR为78.3%,中位TTP为7.0个月。NP组近期有效率16.7%(5/30),其中CR0例,PR5例(16.7%),NC17例(56.7%),PD8例(26.7%),RR为17.4%(5/30),DCR为73.3%(22/30),中位TTP为6.5个月。两组的有效率及TTP比较未见有统计学差异(P>0.05)。主要毒副反应为恶心、呕吐、脱发及骨髓抑制等,发生率相似。所有毒副反应均能耐受。结论:HEP方案治疗多次化疗失败的晚期乳腺癌患者疗效可靠,毒副反应可耐受,经济花费少,可以考虑作为晚期乳腺癌经多次化疗失败后的另一优选方案。

Clinical study of comparison of HEP regimen and NP regimen in patients with advanced breast cancer failing previous chemotherapy

Objective:To determine the efficacy and tolerance of HEP regimen and NP Regimen in advanced breast cancer failing previous chemotherapy. Methods:A total of pretreated breast cancer 53 patients proved pathologically were divided into HEP and NP groups. HEP group(23 patiemts):received Hydroxy 6mg/m2,iv drip d1-d5, Etoposide 0.1 iv drip d1-d5,Cisplatin 20mg iv drip d1-d5. NP group(30 patiemts):Vinorelbine 25mg/m2 iv drip d1, d5, Cisplatin 20mg iv drip d1-d5. The treatment were repeated every 4 weeks for 2-4 cycles. Results:In HEP group, The objective response rate was 17.4%(4/23), the mean time to progress (TTP) was 7.0 months. In NP group, The objective response rate was 16.7%(5/30), the mean time to progress (TTP) was 6.5 months. The main toxicities were nausea, vomit, alopecia and neutropenia. There was no significant difference between the two groups. All side effects were tolerable. Conclusion:HEP regimen is efficacious in the treatment of advanced breast cancer failing multiple previous chemotherapy. The toxic reactions are tolerable.