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目的:评价健择联合顺铂治疗蒽环类耐药的晚期乳腺癌临床疗效及不良反应。方法:23例经含蒽环类抗生素方案治疗失败或进展的乳腺癌患者采用健择联合顺铂的化疗方案,第1及第8天健择(GEM)1 000 mg/m2;第1~5天顺铂(DDP)20 mg/m2,21 d为1周期。按UICC实体瘤疗效评定标准评疗效,至少治疗2周期后评价疗效,有效病例1个月后再确认疗效。按WHO抗肿瘤药物毒性分级标准评价不良反应。结果:总有效率[完全缓解(CR)+部分缓解(PR)]为43.5%,其中完全缓解1例,部分缓解9例,稳定(SD)8例,进展(PD)5例。临床受益率CBR(CR+PR+SD)为78.3%。单一器官转移病例的有效率(CR+PR)为55.6%(5/9),其中CR 1例;多器官转移病例的有效率(CR+PR)35.7%(5/14),无CR病例。不良反应主要表现为骨髓抑制,以血小板减少最明显,但无一例发生血小板减少相关的并发症。胃肠反应的恶心、呕吐经对症处理均能耐受,极个别病例出现一过性转氨酶、尿素氮升高。结论:健择联合顺铂治疗蒽环类耐药的晚期乳腺癌具有良好的效果,不良反应可以耐受。
Objective: To evaluate the clinical efficacy and adverse reactions of gemcitabine combined with cisplatin in the treatment of anthracycline-resistant advanced breast cancer. METHODS: Twenty-three patients with breast cancer who had failed or progressing with anthracycline-containing regimens were treated with chemotherapy with gemcitabine plus cisplatin, GEM 1000 mg / m2 on day 1 and day 8, DDP 20 mg / m2, 21 days for 1 cycle. According to UICC solid tumor evaluation criteria for efficacy evaluation, at least 2 weeks after treatment evaluation of the effectiveness of effective cases and then confirm the effect after 1 month. According to WHO anti-tumor drug toxicity rating criteria for evaluation of adverse reactions. Results: The total effective rate (CR) + partial response (PR) was 43.5%. One was completely relieved, the other 9 were partially relieved. Eight cases were stable and 5 were PD. Clinical benefit rate CBR (CR + PR + SD) was 78.3%. The response rate of single organ metastasis was 55.6% (5/9), of which 1 was CR. The CR rate was 35.7% (5/14) in patients with multiple organ metastases without CR. Adverse reactions mainly manifested as myelosuppression, the most obvious thrombocytopenia, but no case of thrombocytopenia-related complications. Gastrointestinal nausea, vomiting can be tolerated symptomatic treatment, a very few cases of transient transaminase, elevated urea nitrogen. Conclusion: Gemcitabine combined with cisplatin in the treatment of anthracycline-resistant advanced breast cancer has a good effect, adverse reactions can be tolerated.