紫杉醇联合顺铂治疗57例晚期乳腺癌的临床疗效分析

目的：观察紫杉醇联合顺铂（DDP）方案治疗晚期乳腺癌（ABC）及蒽环类耐药性乳腺癌的疗效与安全性.方法：采用紫杉醇联合DDP方案治疗ABC 57例（其中含蒽环类耐药性乳腺癌26例）.紫杉醇175 mg/m^2,静脉滴入,d1（或分为d1、d8）;DDP 70 mg/m^2,静脉滴入,d1（或分为d1～d3）,加水化、利尿和止吐治疗,21 d为1个周期.本组中位化疗周期数为3个.结果：完全缓解6例,部分缓解24例,稳定16例,疾病进展11例,总的有效率52.6%（30/57）,26例蒽环类耐药性乳腺癌患者的有效率为61.5%（16/26）.治疗时一般情况较好者疗效（53.5%）好于一般情况差者（23.3%）,P=0.045.中位肿瘤进展时间7个月,1年生存率为61.4%,中位生存期为19个月.主要毒性反应为骨髓抑制及胃肠道反应.结论：紫杉醇和DDP联合方案治疗ABC,特别是蒽环类耐药性乳腺癌疗效较好,使用方便,毒性反应较轻.该方案是包括蒽环类耐药性ABC的有效解救治疗方案.

Paclitaxel and cisplantin in the second-line treatment of advanced breast carcinoma

OBJECTIVE:To evaluate the efficacy and safety of chemotherapy of paclitaxel(PTX)combined with cisplantin(DDP)for advanced breast cancer,including anthracycline-resistant advanced breast cancer(ABC).METHODS:57 patients with ABC(including 26 patients with anthracycline-resistant ABC)were treated with combination chemotherapy of PTX and DDP.PTX 175 mg/m2,DDP 70 mg/m2 were used on day 1 every three weeks.The median number of cycles was 3.RESULTS:The overall response rate was 52.6% with a median time to progression of 7 months.One-year survival rate was 61.4%.The response rate in 26 patients with anthracycline-resistant ABC was 61.5%.Patients with good performance statue have higher response rate than those with bad performance statue.The main side effects were gastrointestinal and hematologic toxicities.CONCLUSION:Paclitaxel and cisplantin combination is active in the treatment for ABC expecially for anthracycline-resistant ABC patients with acceptabale toxicity,and may be a therapeutic alternative after anthracycline regimen has faild.