【摘要】 目的观察紫杉醇脂质体联合卡培他滨(TX)治疗老年晚期三阴乳腺癌(TNBC)的疗效及发生不良反应情况。方法回顾性分析该院2013年1月至2015年1月收治的54例临床分期为ⅢA~C、Ⅳ期的原发性老年晚期TNBC患者的临床资料,将其分为TX组和紫杉醇脂质体联合顺铂(TP)组各27例。TX组:紫杉醇脂质体150 mg/m~2,第1天静脉滴注,卡培他滨1 000 mg/m~2,第1~14天口服,每天2次,同时给予维生素B630 mg口服,每天3次,预防手足综合征,21 d为1个周期;TP组:紫杉醇脂质体150 mg/m~2,第1天静脉滴注,顺铂25 mg/m~2,第1~3天静脉滴注,21 d为1个周期。2个周期后评价两组疗效,最多不超过6个周期。待所有患者完成化疗后对比分析两组近期疗效及不良反应。结果54例老年晚期TNBC辅助化疗中,总有效率为68.5%(37/54)。TP组有效率[63.0%(17/27)]高于TX组[74.1%(20/27)],但差异无统计学意义(χ~2=0.773,P=0.379);TX组手指足综合征发生情况明显高于TP组,差异有统计学意义(χ~2=44.220,P=0.000);且TP组恶心、呕吐反应发生情况明显高于TX组,差异有统计学意义(χ~2=14.172,P=0.001);两组脱发,肝、肾功能异常和血液学毒性发生情况比较,差异均无统计学意义(P>0.05)。结论在临床分期为ⅢA~C、Ⅳ期老年晚期TNBC患者的辅助化疗中,TX方案与TP方案近期疗效相当。TX方案减轻了老年晚期TNBC患者胃肠道反应的发生情况,但手足综合征的发生情况增加;因此,在提前预防手足综合征的情况下,TX方案可以作为老年晚期TNBC辅助化疗方式之一。更多还原

【Abstract】 Objective To observe the efficacy and adverse reactions of docetaxel liposome combined with capecitabine(TX)in the treatment of elderly advanced 3-negative breast cancer(TNBC). Methods The clinical data in 54 cases of clinical stageⅢA~C,Ⅳ of elderly advanced TNBC in this hospital from January 2013 to January 2015 were retrospectively analyzed. All patients were divided into the TX group and docetaxel liposome combined with cisplatin group(TP),27 cases in each group. TX group was given docetaxel liposome 150 mg/m~2 by intravenous drip on 1 d and oral TX 1 000 mg/m~2 on 1-14 d twice daily,meanwhile oral vitamin B630 mg,3 times daily,for preventing hand-foot syndrome,with 21 d as 1 cycle;the TP group was given docetaxel liposome 150 mg/m~2 by intravenous drip on 1 d and cisplatin 25 mg/m~2 by intravenous drip on 1-3 d,with 21 d as 1 cycle. The efficacy was evaluated after 2 cycles,not more than 6 cycles. The short-term efficacy and adverse reactions were analyzed and compared between the two groups after finishing chemotherapy in all the cases. Results In the adjuvant chemotherapy of 54 cases of elderly advanced TNBC,the total effective rate was 68.5%(37/54),the effective rate in the TP group was higher than that in the TX group without statistical difference[63.0%(17/27)vs.74.1%(20/27),χ~2=0.773,P=0.379];the occurrence rate of hand-foot syndrome in the TX group was significantly higher than that in the TP group,the difference was statistically significant(χ~2=44.220,P =0.000),moreover the occurrence rates of nausea and vomiting in the TP group was significantly higher than that in the TX group,the difference was statistically significant(χ~2=14.172,P=0.001);but the occurrence of hair loss,liver and kidney function abnormality and hematological toxicology had no statistically significant difference between the two groups(P>0.05). Conclusion In the adjuvant chemotherapy of clinical stageⅢ A-C and Ⅳ of elderly advanced TNBC,the TX regimen and TP regimen have the same short-term effect. The TX regimen alleviates the occurrence of gastrointestinal reactions,but the occurrence of hand-foot syndrome is increased;therefore in that case of preventing this complication in advance,the TX regimen may serve as one of adjuvant chemotherapeutic regimens in elderly advanced TNBC.更多还原