摘要
目的观察乳腺癌骨转移患者化疗后的骨髓抑制程度。方法收集183例伴有骨转移的晚期乳腺癌患者为研究组,86例晚期无骨转移的乳腺癌患者为对照组。平均化疗2周期后,比较两组的骨髓抑制情况和其它不良反应。结果研究组化疗后白细胞、粒细胞、血小板及红细胞下降Ⅲ～Ⅳ度的发生率分别为46.6%、48.1%、37.2%和24.0%,对照组为31.4%、26.7%、16.3%和11.6%,差异有统计学意义(P<0.05)。研究组FEC/CEF方案白细胞、粒细胞、血小板下降Ⅲ～Ⅳ度的发生率分别为60.8%、62.7%、37.3%,对照组为32.0%、36.0%、12.0%,差异有统计学意义(P<0.05),Ⅲ～Ⅳ度红细胞下降的发生率两组分别为27.5%和8.0%,差异无统计学意义(P>0.05)。AT方案白细胞、粒细胞、血小板和红细胞下降Ⅲ～Ⅳ度的发生率研究组为65.1%、69.8%、36.5%和26.9%,对照组为39.3%、32.1%、14.2%和7.1%,差异有统计学意义(P<0.05)。XT方案白细胞、粒细胞、血小板和红细胞下降Ⅲ～Ⅳ度的发生率研究组为16.7%、14.3%、21.4%和14.3%,对照组为14.3%、9.5%、9.5%和14.3%,差异无统计学意义(P>0.05)。白细胞、血小板、红细胞的骨髓抑制最低点出现时间研究组分别为第8、12、16天,对照组为第12、16、18天,差异有统计学意义(P<0.05)。研究组Ⅲ～Ⅳ度神经毒性发生率为16.9%,对照组为7.0%,差异有统计学意义(P<0.05)。研究组Ⅲ～Ⅳ度感染发生率为9.8%,对照组为2.7%,差异有统计学意义(P<0.05)。结论乳腺癌骨转移患者化疗后总体的骨髓抑制较无骨转移的晚期乳腺癌严重,神经毒性和感染的发生率较高,应注意药物的选择和剂量调整。
Objective To investigate the degree of bone marrow suppression after chemotherapy in patients of breast cancer with bone metastasis. Methods One hundred and eighty-three cases of advanced breast cancer patients with bone metastasis at the time of hospitalization were analyzed as experimental group, and 86 cases of advanced breast cancer patients without bone metastasis as control group. The degree of bone marrow suppression and other adverse reactions were compared after average two cycles of chemotherapy were given. Results The incidence of Ⅲ - Ⅳ degree of leucopenia, granulopenia, thrombocytopenia and erythropenia was 46. 6% ,48. 1% , 37.2% and 24. 0% in the experimental group, compared with that of 31.4% ,26. 7%, 16. 3% and 11.6% in control group （P 〈 0. 05）. The incidence of Ⅲ- Ⅳ degree of leucopeuia, grauulopenia and thromhocytopenia was 60. 8% , 62. 7% , 37.3% in the experimental group given FEC/CEF chemotherapy, compared with that of 32. 0% , 36. 0% , 12. 0% in control group （P 〈 0. 05 ）. The incidence of Ⅲ- Ⅳ degree of erythropenia was 27.5% in the experimental group compared with that of 8.0% in control group（P 〉 0. 05 ）. The incidence of Ⅲ - Ⅳ degree of leucopenia, granulopenia, thromboeytopenia and erythropenia was 65.1% , 69.8% , 36. 5 % and 26. 9% in the experimental group given AT chemotherapy, compared with that of 39. 3% ,32. 1% , 14. 2% and 7.1% in control group（P 〈 0. 05）. The incidence of Ⅲ- Ⅳ degree of leueopenia, granulopenia, thrombocytopenia and erythropenia was 16. 7%, 14. 3% ,21.4% and 14. 3% in the experimental group given XT chemotherapy, compared with that of 14. 3%, 9. 5%, 9. 5% and 14. 3% in control group（P 〉 0. 05）. The lowest point of leucopenia,thrombocytopenia and erythropenia happened in d 8, d 12 and d 16 in the experimental group,compared with that of d 12, d 16, d 18 in control group （P 〈 0. 05 ）. The incidence of Ⅲ- Ⅳ degree of neurotoxicity was 16. 9% in the experimental group compared with that of 7.0% in control group （P 〈0. 05）. The incidence of m - Ⅳ degree of infection was 9. 8% in the experimental group compared with that of 2. 7% in control group （ P 〈 0. 05 ）. Conclusions Patients of advanced breast cancer with bone metastasis have a more serious bone marrow suppression, as well as neurotoxicity and higher infection rate than those without bone metastasis. More attention should be payed to the choice of drug and dose adjustments.
出处
《实用肿瘤杂志》
CAS
2013年第3期287-291,共5页
Journal of Practical Oncology
关键词
乳腺肿瘤
肿瘤转移
药物疗法
骨髓抑制
感染
breast neoplasms
neoplasm metastasis
drug therapy
bone marrow suppression
infection
