紫杉醇单药每周方案治疗老年转移性乳腺癌的临床疗效观察

目的分析紫杉醇单药每周方案治疗老年转移性乳腺癌的疗效及安全性。方法本科于2004年至2007年间收治了33例经病理证实的晚期转移性乳腺癌患者，年龄65～74岁，中位年龄68岁，复发转移后初治的19例患者为一线治疗组，既往接受其他化疗的14例患者为二线治疗组，两组均接受紫杉醇单药治疗80mg／m^2，第1、8、15天应用，28d为1个周期。应用紫杉醇前常规采用地塞米松、苯海拉明、西咪替丁等抗过敏处理。应用SPSS10．0统计软件进行统计学处理，采用Fisher检验比较组间的疗效和生存情况。结果可评价疗效病例33例，总有效率为39％，其中完全缓解（complete response，CR）1例（3％），部分缓解（partial response，PR）12例（36％），稳定（stable disease，SD）9例（27％）、进展（progressing disease，PD）11例（33％）。一线治疗组CR1例，PR7例；二线治疗组CR0例，PR5例，两组疗效差异无统计学意义（x^2=0．13，P=0．26）。中位化疗周期为6个，临床受益（CR＋PR＋SD）22例（67％），中位肿瘤进展时间（TTP）为5．8个月，中位总生存时间（OS）是16．1个月。不良反应主要为骨髓抑制和神经肌肉毒性，毒性反应分级为Ⅰ～Ⅱ度，未见严重不良反应。结论对于老年转移性乳腺癌患者，单药紫杉醇每周方案疗效是肯定的，耐受性良好，极少引起严重的血液学及非血液学毒性，对于一般情况差的老年患者仍然有效。

Efficacy and toxicity of weekly palitaxel therapy for elderly metastatic breast cancer patients

Objective To evaluate the efficacy and toxicity of weekly palitaxel therapy for elderly metastatic breast cancer patients. Methods From 2004 to 2007, 33 patients,aged ≥65 years （median age 68 years）, with advanced metastatic breast cancer were admitted and treated in our department. All patients were confirmed pathologically. Among them, patients receiving initial paclitaxel therapy after recurrence and metastasis were taken as the first line therapy group （n= 19）, and patients who had received other chemotherapy before were taken as the second line therapy group. All patients were given paclitaxel at a dose of 80 mg/m^2 weekly on days 1,8 and 15 of a 28-day cycle. Premedications consisted of diphenhydramine, cimetidene and dexamethasone. SPSS10. 0 was used for stastistcal analysis. Comparison of efficacy, adverse effect and overall survival between the two groups was performed using Chi-square test. P〈 0. 05 was considered statistically significant. Results All the 33 patients were evaluable. The overall response rate （ORR） was 39% （13/33）. Complete response （CR） was in one patient （3%）, partial response （PC） in 12 （12%）, stable disease （SD） in 9 （27%）, and progressing disease （PD） in 11 （33%）. In the first line therapy group CR was in 1 case and PR in 7 cases; in the second line therapy group 5 cases obtained PR, with no statistical difference between the two groups（P= 0.26）. The median chemotherapy cycle was 6 cycles. Twenty-two patients （67%） had clinical benefit. The median TTP （time to progression） was 5.8 months, and the median overall survival（OS）was 16.1 months. The adverse effect was mainly myelosuppression and toxicity in neuromuscle. Grade Ⅰ--Ⅱ toxicity was neutropenia and neuropathy. Conclusion For elderly metastatic breast cancer patients, paclitaxel as a single agent therapy given weekly is effective and well tolerated. Importantly, this regimen causes a low incidence of severe hematologic and non-hematologic toxicities. And i