多西他赛联合吡柔比星与顺铂2种方案治疗晚期乳腺癌的临床疗效观察

目的:比较多西他赛联合吡柔比星(TT)与顺铂(TP)2种方案治疗晚期乳腺癌的临床疗效和不良反应。方法:TT组采用吡柔比星40～50 mg.m-2,静脉注射,d1;多西他赛75 mg.m-2,静脉滴注1 h,d2。TP组采用多西他赛75 mg.m-2,静脉滴注1h,d1;顺铂75～80 mg.m-2(分2～3 d),静脉滴注,d2～3或d4;2组使用多西他赛前30 min分别静脉注射地塞米松10 mg和西咪替丁300 mg,并于10 h后开始口服地塞米松8 mg,每日2次,连服3 d;化疗前30 min静脉滴注托烷司琼5～6 mg。以上每3～4周为1个周期,至少完成2个周期。结果:69例患者共接受190个周期的化疗,每例至少完成2个周期,均可评价疗效。2组总有效率(RR)为50.7%(35/69);TT方案组RR为52.8%(19/36),CR为13.9%(5/36);TP方案组RR为48.5%(16/33),CR为6.1%(2/33),2组近期疗效比较差异无统计学意义,P>0.05。TT组脱发发生率为100%(36/36),高于TP组的54.5%(18/33),2组比较差异有统计学意义,P<0.05;而骨髓抑制、恶心、呕吐和腹泻及Ⅲ+Ⅳ度毒性反应,2组比较差异均无统计学意义,P>0.05。结论:TT和TP方案治疗晚期乳腺癌患者,疗效相近,RR较高,不良反应可以耐受。

Efficacy of Docetaxel Combined with either Pirarubicin or Cisplatin for Advanced Breast Cancer

OBJECTIVE: To evaluate the clinical efficacy and toxicity of docetaxel combined with either pirarubicin(TT) or cisplatin(TP) for advanced breast cancer.METHODS: TT group received pirarubicin by intravenous injection(40-50 mg·m-2) on day 1 and docetaxel(75 mg·m-2) by intravenous drip for 1 hour on day 2;TP group received docetaxel(75 mg·m-2) by intravenous drip infusion for 1 hour on day 1 followed by administration of cisplatin(at a total dose of 5-80 mg·m-2 in a total of 2-3 days) from day 2 to day 3 or to day 4 by intravenous drip infusion.Both of the two groups received 10 mg of dexamethasone and 300 mg of cimetidine by intravenous injection 30 min prior to administration of docetaxel followed by oral administration of dexamethasone(8 mg,b.i.d) 10 hrs later for 3 consecutive days;and the patients received tropisetron iv gtt 30 min before chemotherapy.The patients received treatment for at least 2 cycles with 1 cycle defined as 3-4 week treatment.RESULTS: 69 patients have received a total of 190 cycles of chemotherapy with every patient treated for at least 2 cycles and all the 69 cases were eligible for evaluation of curative efficacy.The overall response rate(RR) was 50.7%(35/69),with RR of 52.8%(19/36) and CR of 13.9%(5/36) for TT group,as compared with RR of 48.5%(16/33) and CR of 6.1%(2/33) for TP group,showing no significant differences between the two groups in short-term efficacy curative effect(P>0.05).The rate of alopecia in TT group was higher than in TP group 100%(36/36) vs.54.5%(18/33),P<0.05],however,the differences between the two groups in myelosuppression,nausea and vomiting,diarrhea and toxicity(grade Ⅲ and grade Ⅳ) were not statistically significant(P>0.05).CONCLUSION: TT regimen and TP regimen were similar in efficacy with high response rate yet tolerable toxicity for patients with advanced breast cancer.