重组人血管内皮抑素联合NP方案治疗晚期乳腺癌临床观察

目的应用重组人血管内皮抑素(恩度)联合长春瑞滨+顺铂(NP)方案治疗晚期乳腺癌,与单纯长春瑞滨+顺铂方案相比较,探讨其疗效、安全性及耐受性。方法选择2009年2月—2012年8月该院收治的36例经病理证实的晚期乳腺癌患者,其中16例应用恩度联合NP方案治疗,20例单纯NP方案化疗。恩度15 mg加生理盐水500 mL匀速缓慢静脉滴注3 h,d 1~14;长春瑞滨:25 mg/m2,d1、8;顺铂:25 mg/m2,d 2~4。3周重复。按照RECIST1.1标准评价近期疗效,按照NCI.CTC3.0版标准评价毒性反应,用药2周期后评价疗效及毒性。结果 36例患者均完成至少2周期治疗,可评价疗效。恩度联合NP组:CR 3例、PR 6例、SD 5例、PD 2例。客观有效率(RR)56.3%,疾病控制率(DCR)87.5%。C3/4级毒性:中性粒细胞下降4例(25%),血小板下降1例(6.25%),恶心、呕吐1例(6.25%)。NP治疗组:CR 2例、PR 6例、SD 6例、PD 6例。客观有效率(RR)40%,疾病控制率(DCR)70%。C3/4级毒性:中性粒细胞下降5例(25%),血小板下降2例(10%),恶心、呕吐2例(10%)。两组之间RR及DCR差异有统计学意义(P<0.05)。结论恩度联合NP方案治疗晚期乳腺癌可提高NP方案疗效,未增加毒性反应,安全性好,并可改善患者的生活质量,值得临床推广应用。

Clinical Observation of the Therapeutic Effect of Rh-endostatin (Edostar,YH-16) Combined with Vinorelbine and Cisplatin on Terminal Breast Cancer

Objective To evaluate the efficacy, drug safety and tolerability of Edostar combined with vinorelbine and cisplatin on terminal breast cancer. Methods 36 cases stage IV breast cancer patients proved by pathology, admitted in our hospital from February, 2009 to August, 2012 were selected. 16 cases were treated with Edostar combined with vinorelbine and cisplatin and 20 cases were treated with vinorelbine and eisplatin. Edostar（15 mg in 500 ml saline） was injected intravenously for three hours in the first 14 days. Vinorelbine（ 25 mg/m2） was injected intravenously for the first ang eighth days. Cisplatin （25 mg/m2） was injected in- travenously for the second to fourth days. Three weeks repeated. Then evaluated the effect by RECIST 1.1, adverse reactions by NCI.CTC3.0. The efficacies and adverse reactions were evaluated after two courses of treatment. Results Edostar combined with NP：CR 3 cases, PR 6 cases, SD 5 cases, PD 2 cases. RR 56.3%,DCR 87.5%. The stage G 3/4 adverse reactions were： The de- creasing levels of neutmphil 4 cases （25%）, the decreasing levels of platelet ! case （6.25%）,nausea and vomit was took place in 1 case （6.25%）. NP：CR 2 cases, PR 6 cases, SD 6 cases, PD 6 cases. RR 40%,DCR 70%~ The stage G 3/4 adverse reactions were： The decreasing levels of neutrophil 5 cases （25%）, the decreasing levels of platelet 2 cases （10%）,nausea and vomit was took place in 2 cases（10%）. There were statistically significant differences in ORR and DCR between the two groups（P〈0.05）. Conclu- sion The Edostar combined with NP has better therapeutic effects on terminal breast cancer than NP with good safety and less ad- verse reactions, and it can improve the life quality of the patients, which is deserved to be utilized widely in clinic.