长春瑞滨联合顺铂治疗蒽环类和紫杉类耐药晚期乳腺癌的临床观察

目的 观察长春瑞滨联合顺铂（NP）治疗蒽环类和紫杉类耐药的晚期乳腺癌的疗效及不良反应.方法 43例蒽环类和紫杉类治疗后失败的晚期乳腺癌患者接受NP方案化疗：长春瑞滨25 mg/m2 d1,8;顺铂20～25 mg/m2 d1～3;每21d为一个周期.患者最多接受6个周期化疗或至疾病进展.结果 43例患者共完成148个周期化疗,中位化疗周期3个周期,均可评价疗效和不良反应.其中完全缓解3例（7.0％）,部分缓解18例（41.9％）,稳定16例（37.2％）,进展6例（14.0％）,总缓解率为48.8％,肿瘤控制率为86.0％.不良反应有骨髓抑制、胃肠道反应、肝肾功能损害及外周神经炎等,多为Ⅰ～Ⅱ级毒性反应,Ⅲ～Ⅳ级毒性反应有白细胞减少、血小板减少及恶心呕吐.结论 NP方案治疗蒽环类和紫杉类耐药的晚期乳腺癌疗效较好,其不良反应可以耐受,可推荐作为耐药晚期乳腺癌的解救方案.

Clinical observation of vinorelbine combined with cisplatin in the treatment of patients with anthracycline and taxane-refractory advanced breast cancer

Objective To observe the efficacy and toxicities ofvinorelbine combined with cisplatin （NP） in the treatment of anthracycline-and taxane-refractory advanced breast cancer.Methods Forty-three patients with anthracycline-and taxane-refractory advanced breast cancer were enrolled in this study.All patients were treated with NP protocol：vinorelbine was given at a dose of 25 mg/m2 on day 1 and day 8; cisplatin was given at a dose of 20～25 mg/m2 on day 1 to day 3.The combined chemotherapy was repeated every 21 days as one cycle.Patients received a maximum chemotherapy of six cycles or until disease progression.Results The 43 patients completed a total of 148 chemotherapy cycles with a three-cycle median per patients.Among the 43 patients,3 patients achieved complete response （CR）,18 patients achieved partial response （PR）,16 patients had stable disease （SD）,6 patients had progressive disease （PD）.The objective response rate was 48.8%,and the disease control rate was 86.0%.The main adverse effects were hematologic and gastrointestinal toxicities.Liver or renal toxicity and peripheral neuropathy were also observed.Most of adverse effects were grade Ⅰ ～ Ⅱ.Conclusion Vinorelbine combined with cisplatin is effective and well tolerated for patients with anthracycline-and taxane-refractory advanced breast cancer.The combined chemotherapy protocol can be a salvage treatment regimen for resistant advanced breast cancer.