口服小剂量环磷酰胺联合卡培他滨维持治疗晚期三阴性乳腺癌的疗效

目的:观察小剂量环磷酰胺（CTX）联合卡培他滨（CAP）维持治疗晚期三阴性乳腺癌的疗效及安全性。方法:回顾性分析我院收治的经含卡培他滨方案两药联合化疗后达临床稳定的晚期三阴性乳腺癌患者68例，实验组34例给予口服环磷酰胺 50 mg/d，d8~21，每3周重复，联合卡培他滨1 000 mg/m2，bid，d1~14，休息7天。对照组34例患者仅给予口服卡培他滨单药维持治疗。观察2组患者的ORR、DCR、TTP、安全性及对生活质量的影响。结果:经维持治疗后实验组ORR 为29.4%，DCR为85.3%；对照组ORR 为14.7%，DCR为64.7%。实验组中位TTP为12个月，明显高于对照组中位TTP 6.9个月(P＜0.05)。两组的主要不良反应为手足综合征，实验组的胃肠道反应及血液学毒性稍高于对照组，均为Ⅰ-Ⅱ度。两组患者的生活质量评分均较治疗前明显提高，治疗后组间差异无统计学意义(P＞0.05)。结论:口服小剂量环磷酰胺联合卡培他滨维持治疗晚期三阴性乳腺癌有较好的疗效，不良反应可以耐受，可作为复发转移较快的晚期三阴性乳腺癌患者维持治疗的一种选择，具有一定的临床推广应用价值。

The efficacy of oral low-dose cyclophosphamide combined with capecitabine in the treatment of metastatic triple-negative breast cancer

Objective:To investigate the efficacy and safety of low-dose cyclophosphamide（CTX）combined with capecitabine（CAP） maintenance therapy in patients with metastatic triple-negative breast cancer（MBC）.Methods:The clinical data of 68 triple-negative MBC patients treated with capecitabine-based combination chemotherapy were retrospectively analyzed.when initial disease control was achieved by the combination chemotherapy,the experimental group 34 patients were treated with low dose of cyclophosphamide for oral 50 mg,one daily on d8~21 of every 3-week cycle,then capecitabine was continued for oral 1 000 mg/m2,twice daily on d1~14,followed by a 7 d rest period.The control group 34 patients were treated with single-agent capecitabine maintenance therapy.We compared the time to progression (TTP),objective response rate(ORR),disease control rate(DCR),quality of life and safety of the two groups.Results:After combination chemotherapy,the ORR was 29.4%,the DCR was 85.3% in the experimental group.ORR was 14.7%,and DCR was 64.7% in the control group.The median TTP in experimental group and control group were 12 months vs 6.9 months,the difference was statistically significant (P＜0.05).The major gradeⅠ/Ⅱtoxicities included hand-foot syndrome,gastrointestinal toxicities and hematologic toxicity were not significantly different between two groups.The scores of quality of life in two groups were all significantly increased after treatment,and the difference was not statistically significant between two groups(P＞0.05).Conclusion:Oral low dose of cyclophosphamide combined with capecitabine maintenance therapy has clinical curative effect and favorable safety profile in treatment of metastatic triple-negative breast cancer,which provides an option for the advanced triple-negative breast cancer.It has a certain value of clinical promotion and application.