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目的观察吉西他滨联合顺铂治疗晚期乳腺癌的疗效及不良反应。方法采用吉西他滨联合顺铂治疗晚期(术后复发或转移)乳腺癌96例。吉西他滨1000 mg/m2,静脉滴注,第1,8天;顺铂70 mg/m2,静脉滴注,第2天,21~28 d为一周期。结果总有效率为58.3%,中位病情进展时间7个月,中位生存时间20个月,1年生存率为60.2%,3年生存率23.1%,5年生存率5.8%。初治组有效率显著优于复治组(82.7%对29.5%,P<0.05),曾经使用过蒽环类药物和未使用过蒽环类药物患者有效率差异无显著性(51.4%对66.7%,P>0.05),曾经用过紫杉类药物和未使用紫杉类药物患者的有效率差异无显著性(50.0%对51.7%,P>0.05)。有1~2个转移灶组和3个转移灶组有效率差异无显著性(68.9%对48.6%,P>0.05),此方案对于内脏、软组织、淋巴结转移灶有效率相近,骨转移灶有效率相对较低(28.6%)。主要不良反应为骨髓抑制、胃肠道反应、肝肾功能异常,多为Ⅰ~Ⅱ度;Ⅲ~Ⅳ度不良反应主要为白细胞减少和胃肠道反应,发生率分别为16.7%和12.5%。结论吉西他滨联合顺铂治疗晚期乳腺癌具有较好的疗效,不良反应可耐受。
Objective To observe the efficacy and side effects of gemcitabine plus cisplatin in the treatment of advanced breast cancer. Methods 96 cases of advanced (postoperative recurrence or metastasis) breast cancer were treated with gemcitabine plus cisplatin. Gemcitabine 1000 mg / m2, intravenous infusion, on the first day of 1,8; cisplatin 70 mg / m2, intravenous infusion, the first two days, 21 ~ 28 d for a cycle. Results The total effective rate was 58.3%, the median progression time was 7 months, the median survival time was 20 months, the 1-year survival rate was 60.2%, the 3-year survival rate was 23.1% and the 5-year survival rate was 5.8%. The effective rate of the initial treatment group was significantly better than that of the retreatment group (82.7% vs 29.5%, P <0.05). There was no significant difference in the effective rate between the anthracycline and non-anthracycline patients (51.4% vs. 66.7 %, P> 0.05). There was no significant difference in the effective rate between those who used taxanes and those who did not use taxanes (50.0% vs 51.7%, P> 0.05). There was no significant difference in the effective rates between 1 ~ 2 metastases and 3 metastases (68.9% vs 48.6%, P> 0.05). The effective rates of this protocol for visceral, soft tissue and lymph node metastases were similar, The efficiency is relatively low (28.6%). The main adverse reactions were myelosuppression, gastrointestinal reactions, liver and kidney dysfunction, mostly Ⅰ ~ Ⅱ degrees; Ⅲ ~ Ⅳ degrees of adverse reactions are mainly leukopenia and gastrointestinal reactions, the incidence was 16.7% and 12.5%. Conclusion Gemcitabine combined with cisplatin in the treatment of advanced breast cancer has good curative effect and adverse reactions are tolerable.