文章摘要

吉西他滨联合卡培他滨治疗蒽环类和紫杉类耐药的转移性乳腺癌的回顾性分析

作者: 1陈妮娜, 1高桂华, 2王婧
1 北京市怀柔医院肿瘤科,北京101400
2 首都医科大学附属北京友谊医院肿瘤中心,北京 100050
通讯: 王婧 Email: wangjing@bfh.com.cn
DOI: 10.3978/j.issn.2095-6959.2020.08.006
基金: 北京市医院管理局“青苗”计划(QML20150107);北京市临床重点专科项目。

摘要

目的:探讨卡培他滨联合吉西他滨治疗经蒽环类和紫杉类治疗失败的转移性乳腺癌的安全性和有效性。方法:回顾性分析2013年4月至2018年3月在北京怀柔医院治疗的47例经蒽环类和紫杉类治疗失败的转移性乳腺癌患者,采用吉西他滨联合卡培他滨进行治疗,卡培他滨1 000 mg/m2,每日2次口服,第1~14天;吉西他滨1 000 mg/m2静脉滴注,第1,8,21天为1个周期,每2个周期进行评估。6个周期化疗后稳定者可卡培他滨维持治疗。结果:47例患者共接受204个化疗周期。短期疗效分析显示:1例(2.1%)患者获得完全缓解(complete response,CR),16例(34%)患者获得部分缓解(partial response,PR),13例(27.7%)患者获得疾病稳定(stable disease,SD)。中位至疾病进展时间(median time to progress,mTTP)为4.2(95%CI: 1.4~6.3)个月,中位总生存时间(median overall survival,mOS)为11.5(95%CI: 9.6~14.2)个月。3~4级不良反应为嗜中性粒细胞减少(n=7,14.9%),血小板减少(n=7,14.9%),贫血(n=3,6.4%),手足综合征(n=7,14.9%),乏力(n=5,10.6%),肝功能损伤(n=2,4.3%),肾功能损伤(n=2,4.3%),口腔黏膜炎(n=1,2.1%),腹泻(n=2,4.3%)。结论:吉西他滨联合卡培他滨治疗经蒽环类和紫杉类耐药的转移性乳腺癌,不良反应多为I~II级,疗效显著。
关键词: 吉西他滨;卡培他滨;转移性乳腺癌;蒽环类药物;紫杉类药物;耐药

Retrospective analysis of gemcitabine plus capecitabine in the treatment of metastatic breast cancer resistant to anthracycline and taxanes

Authors: 1CHEN Nina, 1GAO Guihua, 2WANG Jing
1 Department of Oncology, Beijing Huairou Hospital, Beijing 101400, China
2 Department of Oncology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China

CorrespondingAuthor: WANG Jing Email: wangjing@bfh.com.cn

DOI: 10.3978/j.issn.2095-6959.2020.08.006

Foundation: This work was supported by Administration of Hospitals’ Youth Programme (QML20150107) and Beijing Key Clinical Specialty Project, China.

Abstract

Objective: To investigate the safety and efficacy of gemcitabine combined with capecitabine in the treatment of metastatic breast cancer after failure of anthracycline and taxanes. Methods: A retrospective analysis was conducted on 47 patients with metastatic breast cancer treated in our hospital from April 2013 to March 2018, gemcitabine and capecitabine were recommended, capecitabine 1 000 mg/m2 twice daily on days 1–14; gemcitabine 1 000 mg/m2 intravenous infusion, days 1 and 8, 21 d per cycle. Capecitabine maintenance therapy was performed after 6 cycles of chemotherapy. Results: Forty-seven patients underwent 204 cycles of chemotherapy altogether. One patient (2.1%) achieved complete responses (CR), 16 (34%) achieved partial responses (PR), and 13 (27.7%) achieved stable disease (SD).The median time to progression was 4.2 months (95%CI: 1.4–6.3), and the median overall survival was 11.5 months (95%CI: 9.6–14.2). Grade 3–4 adverse reactions were neutropenia (n=7, 14.9%), thrombocytopenia (7,14.9%) anemia (n=3, 6.4%), hand-foot syndrome (n=7, 14.9%), fatigue (n=5, 10.6%), liver function injury (n=2, 4.3%), renal function injury (n=2, 4.3%), oral mucositis (n=1, 2.1%), diarrhea (n=2, 4.3%). Conclusion: Gemcitabine plus capecitabine in treatment of metastatic breast cancer previously treated with anthracyclines and taxanes, the efficacy is considerable and the adverse reactions are mild and controllable.
Keywords: gemcitabine; capecitabine; metastatic breast cancer; anthracycline; taxanes; resistance