泰索帝治疗晚期乳腺癌的临床观察

目的：观察泰索帝在治疗晚期乳腺癌中的临床疗效及毒性反应。方法：根据各个病例不同既往化疗史选择不同治疗方案。单用：泰索帝120mg，每1天静脉滴注1小时。顺铂40mg/d，第1天到3天静脉滴注。用泰索帝前24小时开始口服地塞米松7．5mg,2次／日，连服3天。化疗前半小时应用枢丹8mg静注或格拉司琼3mg静注。21天为1周期，治疗3周期评价疗效。结果：泰索帝治疗20例（共62疗程），19例可评价疗效。无完全缓解（CR），部分缓解（PR）4例，无变化（NR）13例和进展（PD）2例，总有效率（CR＋PR）为21％。骨髓抑制为主要毒性反应，20例中有18例至少发生一次Ⅲ度和Ⅳ度的白细胞减少并伴有发热，2例Ⅲ度血小板减少。未发现对红细胞的影响。非血液系统的毒性反应为19例Ⅲ度脱发。5例Ⅲ度／Ⅳ度口腔炎。2例Ⅱ度腹泻。2例双手指甲变色脱落。1例手足麻木。全部病例于应用泰索帝后有面部潮红，但无1例发生严重的过敏反应。大多数病例于应用泰索帝后有肌肉关节疼痛。未发现Ⅱ度以上的恶心呕吐。未发现与治疗有关的肝功能及心电图异常。结论 泰索帝在治疗晚期乳腺癌中具有较好的疗效。主要的毒性反应是白细胞减少伴发热。

Clinical Evaluation of Taxotere for the Treatment of Advanced Breast Cancer

To investigate the response and toxicity of Taxotere for the treatment of advanced breast cancer.Different chemotherapy regimens were selected according to previous chemotherapy of patient.Single usage:Taxotere 120mg iv drip for 1 hour in first day.Combination usage :(1)Taxotere 100mg iv drip for 1 hour in first day,Epirubicin 30 mg/d iv from 1 day to 3 day.(2)Taxotere 100mg iv drip for 1 hour in first day,Cisplatin 40 mg/d iv from 1 day to 3 day.Dexamethasone 7.5 mg po bid at 24 hour before Taxotere and continued for 3 day.Ondansetron 8 mg iv or Granisetron 3 mg iv at half hour before chemotherapy.The second treatment cycle was given after 3 weeks.At last 3 cycles were given.Twenty cases were treated with Taxotere(total 62 cycles),there were 4PR,13NR and 2PD.CR and PR were 21%.The major toxicity were marrow suppression.Grade 3 or 4 neutropenia with fever occurred in 18 cases,grade 3 thrombocytopenia occurred in 2 case. Hemoglobin decrease was not found. Except the major toxicity there were 19 cases with grade 3 alopecia,5 cases with grade 3 or 4 stomatitis,2 cases with grade 2 diarrhea,2 cases with nail hyperpigmentation and onycholysis,1 cases with peripheral neuropathy.Flushing was common in all the cases,but no severe allergy was found.Myalgia or arthralgia was found in many cases following Taxotere administered.Nausea and vomiting over grade 2 were not found.Abnornal liver function and EKG related to treatment were not found also.Conclusion]Taxotere is effective for treatment of advanced breast cancer.The major toxicity is neutropenia with a fever.