CAJ | 학술논문

目的：探讨含卡培他滨不同化疗方案治疗乳腺癌肝转移的疗效及不良反应。方法：收集2000年1月至2011年12月中国医学科学院肿瘤医院收治的163例使用多西他赛/卡培他滨或长春瑞滨/卡培他滨治疗的乳腺癌肝转移患者，回顾性分析临床特点，探讨两种方案的不良反应及疗效。结果：全组共纳入163例患者，接受多西他赛/卡培他滨治疗109例（66.9%），长春瑞滨/卡培他滨组54例（33.1%）。多西他赛/卡培他滨组可评价疗效病例中CR 4例、PR 55例、SD 25例、PD 22例，不详3例，客观有效率为54.1%（59/109），临床获益率77.1%（84/109）；长春瑞滨/卡培他滨组可评价疗效病例中CR 1例、PR 26例、SD 11例、PD 13例，不详3例，客观有效率为50.0%（27/54），临床获益率为70.4%（38/54）。在3～4级血液学不良反应方面长春瑞滨/卡培他滨组发生率为42.6%（23/54），3～4级非血液学不良反应主要表现为手足综合征1例（18.9%）、胃肠道反应2例（3.8%），均高于多西他赛/卡培他滨治疗组。多西他赛/卡培他滨中位无疾病进展时间（progression free survival，PFS）为8个月，中位肝转移后生存（overall survival after liver metastases，LMS）为26个月，中位转移后生存（post metastasis survival，MSR）为30个月；长春瑞滨/卡培他滨组中位PFS为6个月，中位LMS为20个月，中位MSR为28个月。多西他赛联合卡培他滨方案在PFS、LMS以及MSR均较长春瑞滨联合卡培他滨方案延长，但无显著性差异。结论：含卡培他滨化疗方案应用乳腺癌肝转移治疗耐受性良好，其中多西他赛/卡培他滨方案在疗效和耐受性方面可能优于长春瑞滨/卡培他滨方案。
목적：탐토함잡배타빈불동화료방안치료유선암간전이적료효급불량반응。방법：수집2000년1월지2011년12월중국의학과학원종류의원수치적163례사용다서타새/잡배타빈혹장춘서빈/잡배타빈치료적유선암간전이환자，회고성분석림상특점，탐토량충방안적불량반응급료효。결과：전조공납입163례환자，접수다서타새/잡배타빈치료109례（66.9%），장춘서빈/잡배타빈조54례（33.1%）。다서타새/잡배타빈조가평개료효병례중CR 4례、PR 55례、SD 25례、PD 22례，불상3례，객관유효솔위54.1%（59/109），림상획익솔77.1%（84/109）；장춘서빈/잡배타빈조가평개료효병례중CR 1례、PR 26례、SD 11례、PD 13례，불상3례，객관유효솔위50.0%（27/54），림상획익솔위70.4%（38/54）。재3～4급혈액학불량반응방면장춘서빈/잡배타빈조발생솔위42.6%（23/54），3～4급비혈액학불량반응주요표현위수족종합정1례（18.9%）、위장도반응2례（3.8%），균고우다서타새/잡배타빈치료조。다서타새/잡배타빈중위무질병진전시간（progression free survival，PFS）위8개월，중위간전이후생존（overall survival after liver metastases，LMS）위26개월，중위전이후생존（post metastasis survival，MSR）위30개월；장춘서빈/잡배타빈조중위PFS위6개월，중위LMS위20개월，중위MSR위28개월。다서타새연합잡배타빈방안재PFS、LMS이급MSR균교장춘서빈연합잡배타빈방안연장，단무현저성차이。결론：함잡배타빈화료방안응용유선암간전이치료내수성량호，기중다서타새/잡배타빈방안재료효화내수성방면가능우우장춘서빈/잡배타빈방안。
Objective:To evaluate the efficacy and safety of capecitabine-based regimens in treating patients with liver metastases from breast cancer. Methods:A total of 163 patients with liver metastases from breast cancer who received capecitabine-based regimens between January 1, 2000 and Dec 31, 2011 were retrospectively reviewed. The clinicopathological characteristics and treatment outcomes of these patients were evaluated. Results:Of the 163 patients retrospectively analyzed, 109 received docetaxel plus capecitabine (TX) and 54 received vinorelbine plus capecitabine (NX). TX treatment achieved objective responses in 59 patients (54.1%), including complete response in four patients, partial response in 55 patients, and stable disease in 25 patients. In patients who received NX, the objective response and clinical benefit rates were 50.0%and 70.4%, respectively;one patient had a complete response, 26 patients had a partial response, and 11 patients had a stable disease. The safety profiles of TX treatment were more favorable and predictable compared with NX treatment, with a low incidence of grade 3/4 adverse events in hematological and non-hematological toxicities. Results showed that median overall survival after liver metastases (LMS), progression-free survival (PFS), and post-metastasis survival (MSR) were 26, 8, and 28 months in the TX arm. LMS, PFS, and MSR were longer in the TX arm than in the NX arm. Conclusion:Capecitabine-based regimens showed tolerance in patients with liver metastases from breast cancer. TX treatment had a tendency of lower toxicity and was more effective compared with NX treatment.