长春瑞滨联合顺铂治疗蒽环及紫杉类耐药的晚期转移性乳腺癌

目的观察长春瑞滨联合顺铂方案（NP方案）治疗蒽环和紫杉类耐药的晚期转移性乳腺癌的疗效和安全性。方法20例蒽环类和紫杉类方案治疗失败的晚期转移性乳腺癌患者接受：长春瑞滨25mg／m2，静脉滴注，第1天和第8天；顺铂75mg／m2，静脉滴注，第1天，或25mg／m2，静脉滴注，第l一3天；每3周重复。每例患者至少化疗2个周期，每2个疗程评价1次。结果总有效率（CR＋PR）50％，其中CR2例（10％），PR8例（40％），SD4例（20％），PD6例（30％）。中位随访时间6个月（4-18个月），16例存活，4例死亡。中位疾病进展时间5个月（3～15个月）；中位总生存期8个月（4-18个月），1年生存率为60％。主要不良反应为骨髓抑制和消化道反应，Ⅲ-Ⅳ度消化道反应、白细胞下降和血小板下降分别为25％、65％和10％。结论NP方案治疗蒽环类和紫杉类治疗失败的晚期转移性乳腺癌患者疗效可靠且可耐受，可以考虑作为难治性乳腺癌的解救方案。

Clinical observation of vinorelbine combined with cisplatin on advanced metastatic breast cancer resisting to anthracycine and taxane

Objective To evaluate the efficacy and safety of combination chemotherapy with vinorelbine and cisplatin in the treatment of metastatic breast cancer resisting to anthracycline and taxane.Methods 20 patients with advanced metastatic breast cancer were given following regimen:Vinorelbine 25mg/m2 was given intraveniously in day 1 and day 8,cisplatin 75mg/m2 was given intraveniously in day 1 or 25mg/m2 was given intraveniously in day1 to day 3,repeated every 3 weeks.Evaluation of response and adverse reactions were practiced every 2 cycles.Results 20 patients were evaluable,among them,2 cases reach CR,8 cases PR,4 cases SD and 6 cases PD,with a median followup of 6 months(4 ～ 18months),16 patients survived and 4 patients died.The median time to progression and the median survival time was 5 months(3 ～ 15 months) and 8 months(4 ～ 18 months) respectively.The treatment well tolerated,The main toxicity was myelosuppression and gastrointestinal reaction with WHO grade Ⅲ～Ⅳ gastrointestinal reaction,neutropena and thrombocytopenia being in 25% 、65% and 10% .Conclusion The regimen of NP is safe and effective in treating advanced metastatic breast cancer resisting to anthracycline and taxane.In addition,it was able to improve survival rate and adverse reactions could be tolerated.