NP和TP方案治疗乳腺癌复发转移的效果和安全性观察

目的:观察长春瑞滨(NVB)+顺铂(DDP)与紫杉醇(TAX)+DDP两种化疗方案治疗乳腺癌复发转移的临床效果和不良反应。方法:按照随机、平行、对照原则,将89例乳腺癌复发转移患者分为NP组44例和TP组45例,NP组采用NVB+DDP治疗,iv,d1、d8。TP组采用TAX+DDP治疗,iv,d1、d8。以WHO肿瘤疗效标准和毒性反应为评定工具,随访3年,记录死亡情况。结果:NP组完全缓解(CR)7.7%、部分缓解(PR)46.2%、稳定(SD)35.9%、进展(PD)10.3%,TP组CR4.8%、PR47.6%,SD35.7%、PD11.9%,1、2、3年生存率NP组51.28%、33.33%、15.39%,TP组47.62%、30.95%、11.98%,组间差异无统计意义(P>0.05);共同不良反应是骨髓抑制、消化道毒性、脱发,多数患者可以耐受,注射部位反应NP组高于TP组,而神经毒性和肌肉关节疼痛TP组高于NP组,差异有显著统计意义(P<0.01)。结论:NVB+DDP和TAX+DDP的两种联合用药方案对乳腺癌转移复发有确切疗效,如何防止药物不良反应,提高耐受性有待进一步探讨。

The Clinical Therapeutic Effect and Safety of NP and TP Regimen in the Treatment of Metastatic Breast Cancer

Objective：To observe the clinical effect and toxicity reaction of vinorelbine combined with cisplatin and paclitexal combined with cisplatin in the treatment of metastatic recurrent breast cancer. Methods： Adopting parallel, randominzed and controlled-design, 89 patients of the metastatic recurrent breast cancer were divided into NP group（44 cases） and TP group （45 cases）. NP group was treated with vinorelbine combined with cisplatin ,iv,d1 ,ds：and TP group with paclitexal combined with cisplatin, iv, d1, ds. Aeeroding to the effectiveness standard and toxic grading standard suggested by WHO, efficacy and safety were evaluated,followed up for 3 years,and dead cases was recorded. Results NP group＇ s CR was 7. 7 %, PR46. 2 %, SD35. 9 %, PD10. 3 % ; TP group ’s CR was 4. 8 %, PR47. 6 %, SD35. 7 %, PD11. 9%. The 1, 2, 3-year survival rate of NP group was 51. 28%, 33. 33%, 15. 39%, and of the TP group was 47.62%, 30. 95 %, 11.98%. There was no Significant difference between both groups（P〉0. 05）. Tile main toxicity responses of the both groups were the bone marrow suppression, gastroenteric reactions, alopecia, neurotoxicity , which were all mild. NP group was higher than the TP group in local action, but TP group was higher than the NP group in neurotoxicity and muscle and skeletal pain. There was significant difference between the groups（P〈0. 01）. Conclusion： The therapies of vinorelbine combined with cisplatin and paclitexal combined with cisplatin are all effective for the metastatic recurrent breast cancer. Further exploration is necessary for protection against the toxicty reaction of drugs and elevating the drug tolerance.