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目的探讨吉西他滨联合卡培他滨治疗紫杉类治疗失败的晚期乳腺癌的临床疗效及不良反应。方法对2008年3月至2010年2月住院治疗的69例紫衫类及蒽环类治疗失败的晚期乳腺癌患者给予吉西他滨(1000mg/m2)和卡培他滨(1500mg/m2)治疗,3周为1个疗程,至少经过2个疗程的治疗。结果完全缓解3例(4.3%),部分缓解27例(39.1%),稳定22例(31.9%),进展17例(24.6%),总有效率为43.5%,临床获益率为75.4%,中位无进展生存时间为8.2个月,中位生存时间为13.4个月。骨转移患者总有效率为100%,明显高于多发转移、肺部转移和肝脏转移等患者,差异有统计学意义(P<0.05)。绝经前患者临床获益率明显高于绝经后患者,两组比较差异有统计学意义(P<0.05)。不良反应以手足综合征和血小板减少为主,均为可逆性,无治疗相关死亡发生。结论吉西他滨联合卡培他滨治疗紫杉类化疗失败的晚期乳腺癌临床效果显著,对于骨转移患者和绝经前患者的治疗效果更佳。
Objective To investigate the clinical efficacy and adverse reactions of gemcitabine plus capecitabine in the treatment of advanced breast cancer with failed treatment of taxanes. Methods Sixty-nine patients with advanced breast cancer who were hospitalized in the hospital from March 2008 to February 2010 who had failed in treatment with X-ray and anthracycline were treated with gemcitabine (1000mg / m2) and capecitabine (1500mg / m2) Week for a course of treatment, at least after 2 courses of treatment. The results of complete remission in 3 cases (4.3%), partial remission in 27 cases (39.1%), stable in 22 cases (31.9%), progression in 17 cases (24.6%), the total effective rate was 43.5%, clinical benefit rate was 75.4% The median progression-free survival time was 8.2 months and the median survival time was 13.4 months. The total effective rate of patients with bone metastasis was 100%, which was significantly higher than those of patients with multiple metastasis, pulmonary metastasis and liver metastasis, the difference was statistically significant (P <0.05). The clinical benefit rate of premenopausal patients was significantly higher than that of postmenopausal patients, the difference between the two groups was statistically significant (P <0.05). Adverse reactions to hand-foot syndrome and thrombocytopenia, are reversible, non-treatment-related deaths. Conclusion The clinical effect of gemcitabine combined with capecitabine in the treatment of advanced breast cancer with failed chemotherapy of taxanes is significant. The treatment of patients with bone metastases and premenopausal patients is more effective.