【摘要】 目的:比较观察吉西他滨联合顺铂治疗晚期三阴性乳腺癌(triple-negative breast cancer,TNBC)和非三阴性乳腺癌(non-TNBC)的疗效及安全性。方法:回顾性分析菏泽市立医院2008-01-01-2011-06-30符合入组条件的晚期乳腺癌患者180例,根据免疫组化表达情况分为TNBC组(81例)及non-TNBC组(99例)。化疗方案为吉西他滨1 000mg/m2,d1、d8,静脉滴入;顺铂60~70mg/m2,d2、d3、d4,静脉滴入,每21d重复。分析TNBC及non-TNBC患者的临床病例特征、近期疗效、不良反应、无进展生存期及总生存率。结果:180例患者总有效率为33.9%(61/180),疾病控制率为66.7%(120/180)。TNBC组和non-TNBC组的有效率(RR)分别为42.0%(37/81)和27.3%(27/99),差异有统计学意义,χ2=6.155,P=0.046;疾病控制率(DCR)分别为75.3%(61/81)和59.6%(59/99),差异有统计学意义,χ2=4.949,P=0.026。TNBC组和non-TNBC组的中位无进展生存期分别为11.7和14.5个月,差异无统计学意义,P>0.05。总生存期分别为20.6和18.8个月,差异无统计学意义,P>0.05。两组1、2和3年总生存率(OS)分别为73.0%、33.0%、0和73.0%、26.0%、4.0%,差异均无统计学意义,P值均>0.05。主要的毒副作用为骨髓抑制和胃肠反应,两组差异无统计学意义,χ2=0.451,P=0.502。结论:吉西他滨联合顺铂能改善晚期TNBC患者的近期缓解率,在无进展生存期、总生存期方面与non-TNBC组比较无明显优势。更多还原

【Abstract】 OBJECTIVE:To observe the efficacy and safty of gemcitabine and cisplatin combined regimen in advanced triple-negative breast cancer(TNBC)versus non-TNBC.METHODS:From January 1,2008to June 30,2011,we analyzed180cases of advanced breast cancer patiens who had experienced operation and/or chemotherapy and/or radiotherapy and/or endocrine therapy.All patients were divided into two groups according to the expression of immunohistochemistry:TNBC group(81cases)and non-TNBC group(99cases).The patients received 21days per cycle of gemcitabine1 000mg/m2 on day 1and 8,cisplatin,60-70mg/m2,was intravenously dropped from day2to day 4.The clinical pathological features,efficacy progression free survival(PFS),overall survival and the side-effects were evaluated.RESULTS:The total effective rate was 33.9%(61/180)and the disease control rate was 66.7%(120/180)of 180patients.The effective rate was 42.0%(34/81)and the disease control rate was 75.3%(61/81)for TNBC group,27.3%(27/99)and59.6%(59/99)for non-TNBC respectively,and there was significant difference between two groups(P<0.05).The median progression free survival of TNBC and non-TNBC two groups was 11.7months and 14.5months(P>0.05).The median overall survival(OS)of two groups was 20.6months and 18.8months(P>0.05).The main toxicity was myelosuppression and gastrointestinal tract reaction,and the difference between two groups was not significant(P>0.05).1,2,3-year survival rate of the two groups were 73.0%,33.0%,0and 73.0%,26.0%,4.0%respectively(P>0.05).CONCLUSION:The combination chemotherapy of gemcitabine and cisplatin could improve short-time response rate of the advanced TNBC,but couldn’t prolong PFS and OS compared with non-TNBC.更多还原