紫杉醇脂质体联合卡铂治疗耐药三阴性乳腺癌的临床研究

目的：探讨紫杉醇脂质体联合卡铂治疗耐药三阴性乳腺癌的临床疗效和安全性。方法选取91例耐药三阴性乳腺癌患者按随机数字表均分为两组：对照组予顺铂联合长春瑞滨治疗，长春瑞滨针25 mg/m2静脉滴注，第1天和第8天，顺铂针25 mg/m2静脉滴注，第2天和第4天。研究组予紫杉醇脂质体联合卡铂治疗，紫杉醇脂质体针135 mg/m2静脉滴注，第1天，卡铂针5 mg＆#183;ml-1＆#183;min-1，静脉滴注，第2天。21 d为一治疗周期，治疗3个周期后，比较两组生活质量评价疗效改善、骨转移病灶疗效改善、镇痛效果改善、活动能力改善、完全缓解率改善、复发转移率、无进展生存期（PFS）和总生存期（OS）及毒副反应情况发生率等。结果研究组生存质量改善、转移病灶发生率、镇痛效果、活动能力较对照组均有改善，差异均有统计学意义（u分别=1.21、2.32、3.16、3.15，P均＜0.05）。研究组完全缓解率、Kamofsky评分、PFS和OS均高于对照组，复发转移率低于对照组，差异均有统计学意义（χ2=5.33，t分别=6.73、3.97、3.27，χ2=3.24，P均＜0.05）。研究组毒副反应发生率低于对照组，发生程度优于对照组，差异均有统计学意义（Z分别=1.03、1.12、1.39、1.48、2.01、1.79、1.36，P均＜0.05）。结论紫杉醇脂质体联合卡铂治疗耐药三阴性乳腺癌有较好的临床疗效，能有效缓解疼痛，改善临床症状，提高日常生活质量，降低不良反应发生率和发生程度。

Research of paclitaxel liposome combined with carboplatin in treating metastatic triple negative breast cancer

Objective To research the curative effect and safety of paclitaxel liposome combined with carboplatin in treating metastatic triple negative breast cancer. Methods A total of 91 cases of metastatic triple negative breast cancer patients were randomly divided into two groups. The control group was given cisplatin and changchun marina. Changchun marina were intravenous dripped 25 mg/m2 at the first day and eighth day. cisplatin were intravenous dripped 25 mg/m2 at the second day and fourth day. The research group was given paclitaxel liposome and bevacizumab. Paclitaxel liposome were intravenous dripped 135 mg/m2 at the first day. Carboplatin were intravenous dripped 5 mg/ml per minutes at the sec-ond day. 21 days was one course. After 3 courses, the quality of life, bone metastatic lesions, analgesic effect, physical status, the complete response rate, the recurrence rate , progression-free survival（PFS）, over survival（OS） and incidence of adverse reaction conditions were observed. Results The quality of life, bone metastatic lesions occurrence, analgesic effect and physical status of research group were superior to the control group, the difference were statistically significant （u=1.21, 2.32, 3.16, 3.15,P〈0.05）. The complete response rate, Kamofsky score, PFS score and OS score of research group were significantly higher than those of control group while the recurrence rate was lower than the control group （χ2=5.33,t=6.73,3.97,3.27,χ2=3.24,P〈0.05）. The incidence of adverse reaction conditions of research group was significantly lower than that of control group, the severity between two groups was different （Z=1.03,1.12,1.39, 1.48,2.01,1.79,1.36, P〈0.05）. Conclusion Paclitaxel liposome combined with bevacizumab has good effect on metastatic triple negative breast cancer. It can effectively relieve pain, improve the quality of daily life and reduce the incidence of adverse reactions and severity.