吉西他滨联合顺铂一线或二线治疗晚期三阴性乳腺癌的临床观察

目的　观察吉西他滨联合顺铂一线或二线方案治疗晚期三阴性乳腺癌的近期疗效和毒副反应。方法　５４例晚期三阴性乳腺癌患者接受吉西他滨联合顺铂治疗，其中一线治疗４５例，二线９例，具体方案：吉西他滨１０００ｍｇ／ｍ^２ｄ_１、ｄ_８，顺铂２５ｍｇ／ｍ^２ｄ_１～ｄ_３，２１天为１周期。每２周期评价疗效，每周期进行安全性评估。结果　５４例患者中位治疗周期数为６周期（２～８周期），获ＣＲ８例（１４.８％），ＰＲ２４例（４４.４％），ＳＤ１８例（３３.３％），ＰＤ４例（７.４％），总有效率（ＣＲ＋ＰＲ）为５９.２％。主要毒副反应为骨髓毒性和消化道反应，３～４级毒性分别为中性粒细胞减少４０.７％，血小板减少３５.２％，乏力１８.５％，食欲下降１４.８％，贫血１１.１％，恶心呕吐９.２％，外周神经毒性１.９％。结论　吉西他滨联合顺铂治疗晚期三阴性乳腺癌近期疗效好，毒副反应可以耐受，可推荐作为晚期三阴性乳腺癌的治疗选择。

Gemcitabine plus cisplatin as first- or second-line therapy for metastatic triple negative breast cancer

Objective To evaluate the efficacy and safety of combination chemotherapy of gemcitabine and cisplatin（DDP） as first-or second-line therapy for metastatic triple negative breast cancer（TNBC）. Methods Fifty-four metastatic TNBC patients received 21-day cycles of gemcitabine 1000mg/m^2 on day 1 and day 8, and DDP 25 mg/m^2 on day 1 and day 3. Forty-five patients received GP regimen as first-line and 9 as second-line treatment. Response rate was evaluated every two cycles and toxicity was evaluated every cycle. Results The median number of treatment was 6 cycles（2-8 cycles）. The overall response rate was 59.2% , CR 14. 8% , PR 44.4%, SD 33.3% and PD 7.4%. The main treatment-related toxieities were hematologic toxicity and gastrointestinal reaction. Grade 3/4 toxicity included neutropenia 40. 7% , thrombocytopenia 35. 2% , fatigue 18.5% , anorexia 14. 8%, anemia 11. 1% , nausea/vomiting 9. 2% , neuropathy 1.9%. Conclusion Combination therapy of gemcitabine and cisplatin is an effective and well tolerated regimen in metastatic TNBC patients.