吉西他滨联合顺铂治疗三阴性晚期乳腺癌的临床观察

目的:观察吉西他滨联合顺铂方案治疗对蒽环类和紫杉类耐药的晚期三阴性乳腺癌的近期疗效和不良反应。方法:32例对蒽环类和紫杉类耐药的晚期乳腺癌患者，经免疫组化证实ER、PR、HER-2均阴性，给予吉西他滨联合顺铂方案治疗，具体用药为:吉西他滨1000mg/m2静脉滴注，第1、8天；顺铂25mg/m2静脉滴注，第1-3天。21天为1周期，至少2个周期。每周期评价不良反应，每2周期后评价疗效，并随访观察肿瘤进展时间。结果:32例患者均可评价疗效与不良反应，获完全缓解(CR)1例(3.1%)，部分缓解(PR)10例 (31.2%)，稳定(SD)12例(37.5%)，进展(PD)9例(28.1%)，总有效率(CR+PR)为34.4%（11/32）；中位疾病进展时间为5.2个月。主要不良反应包括骨髓抑制和胃肠道反应，Ⅲ-Ⅳ级中性粒细胞减少及血小板减少发生率分别为33.3%和19.0%，无化疗相关性死亡。结论:吉西他滨联合顺铂方案对蒽环类和紫杉类耐药的晚期三阴性乳腺癌有较好的近期疗效，不良反应可耐受，安全性好。

The clinical observation of gemcitabine and cisplatin combination chemotherapy in triple negative metastatic breast cancer

Objective:To evaluate the effects and adverse reactions of gemcitabine and cisplatin combination chemotherapy in anthracycline and taxane-resistant triple negative metastatic breast cancer.Methods:All 32 cases of anthracycline and taxane-resistant advanced breast cancer patients by immunohistochemistry confirmed ER,PR,HER-2 negative,received gemcitabine plus cisplatin regimen.Specific medication as:intravenous gemcitabine 1000mg/m2 infusion,on days 1,8,cisplatin 25mg/m2 intravenous infusion,1 to 3 days.21 days for a period of at least two cycles.Evaluation of adverse events per cycle,and evaluation of effects every two cycles,and follow-up the time to tumor progression.Results:All 32 patients were evaluable for efficacy and adverse reactions,1 patient achieved complete remission (CR) (3.1%),10 patients achieved partial remission (PR) (31.2%),12 patients achieved stable (SD) (37.5%),9 patients achieved progressive disease (PD) (28.1%).Total effective rate (CR+PR) was 34.4% (11/32).Median time to progression was 5.2 months.The main adverse reactions included myelosuppression and gastrointestinal reactions,3 to 4 neutropenia and thrombocytopenia were 33.3% and 19.0%,no chemotherapy-related deaths.Conclusion:Gemcitabine and cisplatin for anthracycline and taxane-resistant advanced triple negative breast cancer have better short-term efficacy,tolerable adverse reactions,and good security.