CAJ | 학술논문

目的探讨白蛋白结合型紫杉醇治疗晚期乳腺癌的近期疗效和安全性。方法回顾性分析34例应用白蛋白结合型紫杉醇单药及联合方案治疗的晚期乳腺癌患者。其中，单药组15例，合并其他抗肿瘤药组19例。一线化疗9例，二线及以上化疗25例。白蛋白结合型紫杉醇每周期剂量范围为170～280 mg/m2，静脉滴注30 min，第1、8天给药，合并抗肿瘤药按常规给药方法给药，21～28 d为1个周期。白蛋白结合型紫杉醇用药前不予抗过敏预处理，每2个周期评估疗效及毒副作用。结果34例患者均可评价疗效，客观有效率（ ORR）35.3％，中位无疾病进展时间（ PFS）为6.1个月。一线治疗患者的ORR明显高于二线及二线以上治疗的疗效，两者具有统计学差异（66.7％ vs．24.0％，P＜0.05）。对于既往使用紫杉类药物耐药的患者ORR为10.0％，临床获益率达90.0％。主要毒副作用包括血液学毒性、消化道反应、感觉神经病变、肌肉关节痛、疲乏、脱发等。结论白蛋白结合型紫杉醇单药及联合方案不仅可以用于晚期乳腺癌的一线治疗，也是二线及二线以上治疗的有效解救方案，对既往紫杉类药物耐药的患者仍可获益，且毒副作用均可耐受。
목적탐토백단백결합형자삼순치료만기유선암적근기료효화안전성。방법회고성분석34례응용백단백결합형자삼순단약급연합방안치료적만기유선암환자。기중，단약조15례，합병기타항종류약조19례。일선화료9례，이선급이상화료25례。백단백결합형자삼순매주기제량범위위170～280 mg/m2，정맥적주30 min，제1、8천급약，합병항종류약안상규급약방법급약，21～28 d위1개주기。백단백결합형자삼순용약전불여항과민예처리，매2개주기평고료효급독부작용。결과34례환자균가평개료효，객관유효솔（ ORR）35.3％，중위무질병진전시간（ PFS）위6.1개월。일선치료환자적ORR명현고우이선급이선이상치료적료효，량자구유통계학차이（66.7％ vs．24.0％，P＜0.05）。대우기왕사용자삼류약물내약적환자ORR위10.0％，림상획익솔체90.0％。주요독부작용포괄혈액학독성、소화도반응、감각신경병변、기육관절통、피핍、탈발등。결론백단백결합형자삼순단약급연합방안불부가이용우만기유선암적일선치료，야시이선급이선이상치료적유효해구방안，대기왕자삼류약물내약적환자잉가획익，차독부작용균가내수。
Objective To evaluate retrospectively the efficacy and safety of albumin-bound paclitaxel in patients with advanced breast cancer .Methods Thirty-four patients with advanced breast cancer treated with albumin-bound paclitaxel were retrospectively analyzed .Fifteen patients were treated with albumin-bound paclitaxel alone,nineteen patients were combined with other anti-tumor drugs.Albumin-bound paclitaxel was administered without premedication at a dose of 170-280 mg/m2 over 30 minutes on day 1 and 8,repeated every 3-4 weeks.Other drugs were administered by the routine methods .The efficacy and safety were assessed every two cycles .Results All patients were evaluable for response .The objective response rate ( ORR) was 35.3%and the median progression-free survival(PFS) was 6.1 months.The ORR of first-line therapy group was significantly higher than that of more than first-line therapy group ( 66.7% vs.24.0%, P <0.05 ) .The ORR and CBR in patients that developed taxanes-resistance after precious taxane treatment were 10%and 90%,respectively.The main toxicities include hematological toxicity, gastrointestinal reactions, sensory neuropathy, myodynia/arthragia, fatigue, alopecia and so on. Conclusions The albumin-bound paclitaxel-based chemotherapy not only can be used in first line but also more than first line therapy .It also showed antitumor activity in taxanes-resistance patients and was better in safety and tolerance.