吉西他滨联合铂类治疗晚期三阴性乳腺癌

目的探讨吉西他滨联合铂类一线治疗既往接受过蒽环或紫杉类药物治疗的晚期三阴性乳腺癌（TNBC）的疗效与安全性。方法 2008年10月至2013年10月以此方案一线治疗晚期TNBC 22例,其中吉西他滨（GEM））＋顺铂（DDP）治疗17例,NVB＋卡铂（CBP）治疗5例,全组共化疗86个周期,中位化疗4个周期（2~8个周期）。结果 22例患者中,完全缓解（CR）1例（4.5%）,部分缓解（PR）9例（40.9%）,稳定（SD）8例（36.4%）,进展（PD）4例（18.1%）,总有效率（CR＋PR）为45.5%,全组中位肿瘤进展时间（TTP）为8.2个月。主要剂量限制性毒性为骨髓抑制和恶心呕吐,骨髓抑制以中性粒细胞减少、血小板减少为主,Ⅲ~Ⅳ度中性粒细胞减少、血小板减少的发生率为36.4%（8/22）、22.7%（5/22）,Ⅲ~Ⅳ度恶心呕吐的发生率为5.0%（1/22）。结论吉西他滨联合铂类一线治疗既往接受过蒽环类药物治疗的晚期TNBC有较好的疗效,且毒性可以耐受,是晚期TNBC一线治疗的有效化疗方案。

Clinical efficacy of gemcitabine combination with platinum in treatment of advanced triple negative breast cancer

Objective：To evaluate the efficacy and safety of combination chemotherapy with gemcitabine and platinum as first - line chemotherapy for advanced triple negative breast cancer（ TNBC）pretreated with anthracyclines and taxanes . Methods：From Oct 2008 to Oct 2013,twenty - two patients with advanced TNBC were treated with gemcitabine and plati-num,containing gemcitabine plus cisplatin for 17 cases,gemcitabine plus carboplatin for 5 cases. A total 86 cycles were ad-ministrated with the median of 4 cycles per patients（range 2 ~ 8）. Results：The overall response rate was 45. 5% with CR 4. 5%. The median time to tumor progression was 8. 2 months. The treatment was well tolerated. The main toxicity was my-elosuppression and gastrointestinal tract toxicity,with grade Ⅲ ＋ Ⅳ neutropenia and thrombocytopenia being in 36. 4%（ 8 /22）and 22. 7%（5 / 22）respectively,and with vomiting being in 5. 0%（1 / 22）. Conclusions：Combination chemotherapy of gemcitabine and platinum as first - line chemotherapy has good anti - tumor activity on patients with advanced triple neg-ative breast cancer pretreated the anthracyclines and taxanes. The adverse reactions are tolerable to the majority of patients. It could be a promising first - line treatment regimen for advanced TNBC.