国产培美曲塞联合卡铂治疗蒽环类及紫杉类治疗失败的晚期转移性乳腺癌的临床观察

目的 观察国产培美曲塞联合卡铂治疗蒽环类及紫杉类治疗失败的晚期转移性乳腺癌的疗效及不良反应。方法 2010年3月至2012年1月收治31例蒽环类及紫杉类治疗失败的晚期转移性乳腺癌患者，给予培美曲塞联合卡铂治疗，具体为：培美曲塞500mg／m²静滴，d₁；卡铂AUC=5静滴，d₂，21天为1周期。全组接受至少2个周期化疗，评价疗效与不良反应。结果31例患者均可评价疗效，获PR 12例，SD 10例，PD 9例；RR为38.7％（12／31），DCR为71.0％（22／31）。KPS评分改善率为67.7％（21／31）。中位肿瘤进展时间为6.0个月（3～14个月），中位生存期为8.3个月（4～18个月）。主要不良反应为骨髓抑制、消化道反应、疲乏和皮疹，以1～2级为主。结论 培美曲塞联合卡铂治疗蒽环类及紫杉类治疗失败的晚期转移性乳腺癌的疗效较好，不良反应可以耐受，值得临床进一步研究。

Clinical observation of pemetrexed combined with carboplatin for anthracycline and taxane-resistant advanced metastatic breast cancer

Objective To observe the efficacy and toxicity of the combination of pemetrexed and carboplatin in the treatment of anthraeycline and taxane-resistant advanced metastatic breast cancer（MBC） patients. Methods Thirty-one patients with advanced MBC failed to previous chemotherapy with anthracycline and taxane were enrolled in the study from March 2010 to January 2012. The patients received pemetrexed（500mg/m2 iv, d~ ） and carboplatin（AUC = 5 iv,d2） with 21 days as a cycle. Each patient received at least two cycles. Results Of the 31 patients, no patient got CR, 12 got PR, 10 cases had SD,9 cases had PD, response rate was 38.7% （ 12/31 ） and the disease control rate was 71.0% （22/31）. The improvement rate of KPS score was 67.7% （21/31）. The me- dian time to progress was 6. 0（3-14） months, the median overall survival was 8.3（4-18） months. The main toxic reactions were my- elosuppression, digestive tract reaction, fatigue and rashes, mainly in grade 1-2. Conclusion The combination of pemetrexed and carboplatin is effective for advanced MBC failed to anthracyclines and taxanes with tolerant toxicity, and worth further study.