摘要
目的观察多西紫杉醇(DOC)联合奥沙利铂(OXA) 不同给药途径治疗耐蒽环类药物的转移性乳腺癌的疗效、生存期及毒副反应.方法选择复发有肝转移的耐蒽环类药物的转移性乳腺癌患者28例,给予DOC 60 mg/m2,OXA 100 mg/m2,第1天,21 d为1个周期.14例(A组)经肝固有动脉灌注(分别持续1 h和2 h),14例(B组)经静脉化疗,每6周CT检查1次.结果 A组CR 1例,PR 12例,SD 1例,有效率为92.9%;B组PR 8例,SD 2例,PD 4例,有效率为57.1%,两组有效率比较差异有显著性(P＜0.05).A组中位生存期为13个月(95%可信区间9.91～16.09),B组中位生存期为6个月(95%可信区间3.68～8.32,P＜0.05);A、B组的1年生存率分别为57.1%和14.3%(P＜0.05).毒性反应主要是粒细胞减少,A组Ⅲ～Ⅳ度粒细胞减少(共78个周期)发生率为16.7%(13/78),B组(共64个周期)为43.8%(28/64),两组比较差异有显著性(P＜0.001);A组感觉神经异常(28.6%)明显少于B组(92.9%,P＜0.001);脱发、恶心呕吐、皮肤病变、黏膜炎、贫血及血小板减少等两组无差别.结论 DOC联合OXA治疗耐蒽环类药物的转移性乳腺癌近期疗效明显,毒性反应可以耐受.经动脉给药较经静脉给药的缓解率高,副反应少,生存期长.
Objective To observe the efficacy ,the patients＇ survival time and the side effects of doeetaxel（DOC） in combination with oxaliplatin （OXA） by different administration routes in treatment of anthraeyeline-resistant metastatic breast cancer（MBC）. Methods Twenty-eight patients with liver metastases and anthracyelineesistant MBC were treated with DOC 60 mg/m2 and OXA 100 mg/m^2 on d1, one cycle was given every 21 days. The drugs were administered through the proper hepatic artery as a 1-hour and 2- hours respectively infusion in fourteen patients（group A） and were administered by venous drip in fourteen patients （ group B）. The CT scan was given every 6 weeks. Results One patient showed complete remission （ CR）, 12 patients showed partial remission （PR） and 1 patient showed stable disease （ SD）, with the response rate being 92.9% in group A while there were 8 PR ,2 SD and 4 progress of disease（PD） B,with the response rate being 57.1% in group B. There was significant difference between group A and group B, P 〈 0.05. The median survival time was 13 months（ 95% CI ：9. 91-16. 09 ） in group A and 6 months（95% CI： 3.68-8.32） in group B,P 〈0.05. The 1-year survival rate were 57.1% and 14.3% respectively in group A and in group B ,P 〈 0.05. The major toxic reactions were neutropenia. Grades 3 and 4 neutropenia occurred in 16.7% of 78 cycles in group A and 43.8% of 64 cycles in group B,P 〈0. 001. Peripheral sensory neuropathy occurred in 28.6% of patients in group A and 92.9% of patients in group B,P 〈0. 001. There was no significant difference between group A and group B in alopecia, nausea and vomiting, skin disorders, mucositis, anemia and thrombocytopenia. Conclusions The regimen of DOC ＋ OXA was effective treatment of anthracycline-resistant MBC and the side effects were tolerable. There were higher response rate and longer survival and lower neurotoxicity when the drugs were administered by arterial injection than by venous drip.
出处
《中国肿瘤临床与康复》
2005年第6期527-529,共3页
Chinese Journal of Clinical Oncology and Rehabilitation
