吉西他滨联合顺铂治疗蒽环类及紫杉类耐药性晚期乳腺癌疗效观察

目的观察吉西他滨联合顺铂治疗蒽环类及紫杉类耐药性晚期乳腺癌的疗效及安全性。方法对2004年10月-2009年7月解放军总医院收治的60例蒽环类及紫杉类耐药性晚期乳腺癌患者采用吉西他滨1 000-1 250mg/m^2,静点第1、第8天,顺铂25mg/m^2,静点第1-3天方案化疗;21d为1个周期。化疗2周期进行疗效评价。化疗期间监测不良反应。结果 60例患者平均化疗周期数为3.7（2-6）,CR1例（1.7%）、PR19例（31.7%）、SD30例（50.0%）、PD10例（16.7%）,总有效率（CR＋PR）33.4%。中位疾病进展时间（TTP）4.2个月。中位生存期（OS）18.3个月。主要不良反应为骨髓抑制和胃肠道反应。结论吉西他滨联合顺铂治疗蒽环类及紫杉类耐药性乳腺癌疗效确切,不良反应可耐受,是治疗蒽环类及紫杉类耐药性晚期乳腺癌的理想补救方案。

Curative effect of combined gemcitabine and cisplatin on anthracycline and taxane-resistant advanced breast cancer

Objective To observe the curative effect and safety of combined gemcitabine and cisplatin for anthracycline and taxane-resistant advanced breast cancer（ABC） patients.Methods Sixty anthracycline and taxane–resistant ABC patients admitted to Chinese PLA General Hospital from October 2004 to July 2009 were treated with gemcitabine（1 000-1 250mg/m^2） on days 1 and 8 and cisplatin（25mg/m^2） on days 1-3 by intravenous drip after admission,21 days as a cycle.Curative effect of chemotherapy was evaluated after 2 cycles of treatment.Side effects of chemotherapy were monitored.Results The 60 patients received 3.7 cycles（range 2-6） of chemotherapy.Of the 60 patients,1（1.7%） showed a complete response,19（31.7%） a partial response,30（50.0%） a stable disease,and 10（16.7%） a progressive disease.The overall response rate was 33.4%.The median progression time of the disease was 4.2 months and the overall survival time of the patients was 18.3 months.The major side effects of chemotherapy were bone marrow inhibition and gastrointestinal reactions.Conclusion Combined gemcitabine and cisplatin therapy is effective and safe for anthracycline and taxane-resistant ABC patients.