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目的探讨长春瑞滨联合顺铂治疗蒽环类和(或)紫杉类耐药晚期乳腺癌的疗效与安全性。方法 43例蒽环类和(或)紫杉类耐药的转移性乳腺癌患者接受长春瑞滨联合顺铂方案化疗:长春瑞滨(法国P ierre Fabre公司产品)25 mg/m2,第1天和第8天,静脉滴注;顺铂75~80 mg/m2,静脉滴注,分割为2~5 d。3周为一周期,每2周期治疗结束后两周评价疗效。结果 43例患者共化疗156个周期,中位化疗周期数为4周期。完全缓解2例(4.7%),部分缓解26例(60.5%),客观有效率为65.1%。41例患者的中位无进展生存期(PFS)9个月,中位生存时间(OS)15个月,其中治疗有效的患者中位无进展生存期为12个月。1年生存率为59.0%。单因素分析显示,肿瘤大小和近期疗效是PFS的影响因素,孕激素受体(PR)状况、三阴性、转移灶数目是OS的影响因素。COX模型多因素回归分析显示,PFS和OS的独立预后因素分别是近期疗效和转移灶数目。主要不良反应是骨髓抑制和胃肠道反应。结论长春瑞滨联合顺铂方案是治疗蒽环类和(或)紫杉类耐药转移性乳腺癌安全有效的解救方案。
Objective To investigate the efficacy and safety of vinorelbine plus cisplatin in the treatment of anthracycline and (or) taxane-resistant advanced breast cancer. METHODS: Forty-three patients with anthracycline and (or) taxane-resistant metastatic breast cancer received chemotherapy with vinorelbine plus cisplatin: vinorelbine (Pierre Fabre, France) at 25 mg / m2 on day 1 And on day 8, intravenous infusion; cisplatin 75 ~ 80 mg / m2, intravenous infusion, divided into 2 ~ 5 d. Three weeks for a cycle, every two weeks after the end of treatment evaluation effect. Results 43 patients were treated with 156 cycles of chemotherapy and the median cycle of chemotherapy was 4 cycles. Complete remission in 2 cases (4.7%), partial remission in 26 cases (60.5%), objective response rate was 65.1%. Eleven patients had a median progression-free survival (PFS) of 9 months and a median survival time (OS) of 15 months, with a median progression-free survival of 12 months for those patients who were effective. One-year survival rate was 59.0%. Univariate analysis showed that tumor size and short-term efficacy were the influencing factors of PFS. The status of progesterone receptor (PR), triple negative and number of metastases were the influencing factors of OS. Multivariate regression analysis of the COX model showed that the independent prognostic factors for PFS and OS were the recent efficacy and the number of metastases, respectively. The main adverse reactions are myelosuppression and gastrointestinal reactions. Conclusions Vinorelbine plus cisplatin is a safe and effective rescue regimen for anthracyclines and (or) taxane-resistant metastatic breast cancer.