卡培他滨联合顺铂治疗晚期三阴性乳腺癌的疗效观察

目的:观察卡培他滨联合顺铂治疗雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体2(HER-2)均阴性(三阴性)晚期乳腺癌的疗效与毒副反应。方法:48例经免疫组化证实ER、PR、HER-2阴性的晚期转移性乳腺癌患者,其中24例患者单用卡培他滨2500mg·m-2,分早晚两次口服,连服14d,21d为1个周期;24例患者接受卡培他滨+顺铂方案:顺铂30mg·m-2静脉滴注,d1～d3,卡培他滨1250mg·m-2,分两次口服,连续服用14d,21d为1个周期。观察2组疗效及毒副反应。结果:卡培他滨单药组与联合化疗组完成疗程数分别为(4.2±0.9)和(4.0±0.7)个疗程。卡培他滨单药组与联合化疗组有效率分别为29.2%和33.4%。其中,卡培他滨单药组24例患者中位疾病进展时间(TTP)为5个月,1年生存率为65.7%;联合化疗组24例患者中位TTP为6个月,1年生存率为67.7%。卡培他滨单药组Ⅲ度手足综合征多于联合化疗组,联合化疗组毒副反应主要为胃肠道反应、白细胞降低、乏力等,经对症处理后均好转。结论:卡培他滨联合顺铂治疗晚期三阴性乳腺癌疗效好,毒副反应可以耐受。

Efficacy Observation of Capecitabine Combined with Cisplatin in the Treatment of Advanced Triple Nega- tive Breast Cancer

OBJECTIVE： To observe efficacy and toxic side effect of capecitabine combined with cisplatin in the treatment of triple negative advanced breast cancer of negative ER, PR, HER-2. METHODS： 48 cases were diagnosed as advanced metastatic breast cancer of negative ER, PR, HER-2 by immunohistochemistry, among which 24 cases received oral dose of capecitabine 2 500 mg.m^-2 alone morning and night for consecutive 14 days, 21 days for the 1 cycle; other 24 cases received capecitabine combined with cisplatin DDP： intravenous infusion of 30 cisplatin mg·m^-2, d1-d3, oral dose of capecitabine in 1 250 mg.m^-2 morning and night for consecutive 14 days, 21 days for the 1 cycle. The number of completed treatment course in monotherapy group and chemotherapy group were （4.2 ±0.9） and （4.0 ± 0.7 ）. RESULTS：The effective rates of capecitabine monotherapy group and chemotherapy group were 29.2% and 33.4%. The median TTP of 24 patients in monotherapy group was 5 months with 1 year survival rate of 65.7%. The median TTP of 24 patients in chemotherapy group was 6 months with 1 year survival rate of 67.7%. The III-degree hand-foot syndrome of capecitabine monotherapy group was slightly more than combination group. Toxic side effect of chemotherapy group were mainly gastrointestinal tract reaction, leucopenia, fatigue, etc., and all recovered after proper treatment. CONCLUSION： Capecitabine combined with cisplatin have good efficacy in the treatment of advanced metastatic triple negative breast cancer patients, and toxic side effects can be tolerated.