培美曲塞联合环磷酰胺治疗复发转移性乳腺癌的疗效观察

目的研究注射用培美曲塞二钠联合注射用环磷酰胺治疗复发转移性乳腺癌的临床疗效。方法选取2013年1月—2015年2月榆林市第二医院收治的乳腺癌患者68例为研究对象,所有患者随机分为对照组和治疗组,每组各34例。对照组第1天静脉滴注注射用培美曲塞二钠500 mg/m~2;第2天静脉滴注注射用奥沙利铂100 mg/m~2。治疗组第1天静脉滴注注射用培美曲塞二钠500 mg/m~2;第2天静脉滴注注射用环磷酰胺500 mg/m~2。两组均以21 d为1个疗程,治疗2个疗程。观察两组的临床疗效,比较两组生活质量和不良反应发生情况以及生存率和复发率情况。结果治疗后,对照组和治疗组的客观缓解率分别为52.9%、76.5%,临床控制率分别为67.6%、88.2%,两组比较差异有统计学意义(P0.05)。治疗后,两组患者的生理状态、心理状态、躯体功能和社会功能评分均明显升高,同组治疗前后比较差异有统计学意义(P0.05);且治疗组这些观察指标明显高于对照组,两组比较差异具有统计学意义(P0.05)。治疗组的肝肾损伤、贫血、心脏毒性、脱发的发生率均明显低于对照组,两组比较差异有统计学意义(P0.05)。治疗后1年,对照组和治疗组生存率分别为61.8%、88.2%,复发率分别为23.5%、2.9%,两组比较差异具有统计学意义(P0.05);治疗后2年,对照组和治疗组生存率分别为52.9%、76.5%,复发率分别为35.3%、5.9%,两组比较差异具有统计学意义(P0.05)。结论注射用培美曲塞二钠联合注射用环磷酰胺治疗复发转移性乳腺癌具有较好的临床疗效,可提高生活质量,改善1、2年期的生存率和复发率,安全性较好,具有一定的临床推广应用价值。

Clinical observation of pemetrexed combined with cyclophosphamide in treatment of recurrent and metastatic breast cancer

Objective To study the clinical efficacy of Pemetrexed Disodium for injection combined with Cyclophosphamide for injection in treatment of recurrent and metastatic breast cancer. Methods Women (68 cases) with recurrent and metastatic breast cancer in Yulin Second Hospital from January 2013 to February 2015 were randomly divided into control and treatment groups, and each group had 34 cases. Women in the control group were iv administered with Pemetrexed Disodium for injection 500 mg/m² at the first day. Then women in the control group were iv administered with Oxaliplatin for injection 100 mg/m² at the second day. Women in the treatment group were iv administered with Pemetrexed Disodium for injection 500 mg/m² at the first day. Then patients in the treatment group were iv administered with Cyclophosphamide for injection 500 mg/m² at the second day. Patients in two groups were treated for 2 courses, 21 d as a course of treatment. After treatment, the clinical efficacies were evaluated, and quality of life, adverse reaction, survival rates and recurrence rates in two groups were compared. Results After treatment, the objective remission rates in the control and treatment groups were 52.9% and 76.5%, respectively, the clinical control rates in the control and treatment groups were 67.6% and 88.2%, respectively, and there was difference between two groups (P<0.05). After treatment, the scores of physiological status, mental state, somatic function, and social function in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly higher than those in the control group, with significant difference between two groups (P<0.05). The incidence rate of liver and kidney injury, anemia, cardiotoxicity, and alopecia in the treatment group were significantly lower than those in the control group, and there was difference between two groups (P<0.05). One year after treatment, the survival rates in the control and treatment groups were 61.8% and 88.2%, respectively, and the recurrence rates in the control and treatment groups were 23.5% and 2.9%, respectively, and there was difference between two groups (P<0.05). Two years after treatment, the survival rates in the control and treatment groups were 52.9% and 76.5%, respectively, and the recurrence rates in the control and treatment groups were 35.3% and 5.9%, respectively, and there was difference between two groups (P<0.05). Conclusion Pemetrexed Disodium for injection combined with Cyclophosphamide for injection has clinical curative effect in treatment of recurrent and metastatic breast cancer, can enhance the quality of life, improve the survival rate and recurrence rate in 1 and 2 years, with good safety, which has a certain clinical application value.