CAJ | 학술논문

目的：分析卡培他滨与铂类在晚期乳腺癌一线、二线治疗中的疗效。方法2010年1月至2013年6月收治317例晚期乳腺癌患者，采用含卡培他滨或铂类的联合化疗方案，每3周为1周期。采用实体肿瘤疗效评价标准1?1版（ RECIST 1?1）评价疗效，不良反应采用NCI CTC 3?0毒性评价标准评价。对采用不同化疗方案的患者进行生存随访并比较其中位无进展生存期（ PFS）。结果一线、二线治疗分别有可评价病例118例和78例。含卡培他滨方案与含铂类方案一线化疗的有效率（53?6％ vs．63?3％）、疾病控制率（81?2％ vs．91?8％）及二线化疗的有效率（42?9％ vs．47?2％）、疾病控制率（90?5％vs．91?7％）的差异均无统计学意义（ P＞0?05）；含卡培他滨方案与含铂类方案的一线化疗的中位PFS分别为15?6个月和12?4个月，差异有统计学意义（ P＜0?05），二线化疗的中位PFS分别为11?1个月和12?8个月，差异无统计学意义（ P＞0?05）。不良反应以血液学毒性、恶心呕吐、手足综合症、乏力、口腔溃疡和腹泻为主；与含铂类方案相比，含卡培他滨方案一线化疗的1、2级恶心呕吐发生率较低，手足综合症发生率较高，而二线化疗的1级恶心呕吐、乏力发生率均较低，手足综合症发生率较高，以上差异均有统计学意义（ P＜0?05）。结论卡培他滨与铂类均对晚期乳腺癌一线、二线治疗有效，卡培他滨安全耐受性较好，一线治疗的中位PFS更长。
목적：분석잡배타빈여박류재만기유선암일선、이선치료중적료효。방법2010년1월지2013년6월수치317례만기유선암환자，채용함잡배타빈혹박류적연합화료방안，매3주위1주기。채용실체종류료효평개표준1?1판（ RECIST 1?1）평개료효，불량반응채용NCI CTC 3?0독성평개표준평개。대채용불동화료방안적환자진행생존수방병비교기중위무진전생존기（ PFS）。결과일선、이선치료분별유가평개병례118례화78례。함잡배타빈방안여함박류방안일선화료적유효솔（53?6％ vs．63?3％）、질병공제솔（81?2％ vs．91?8％）급이선화료적유효솔（42?9％ vs．47?2％）、질병공제솔（90?5％vs．91?7％）적차이균무통계학의의（ P＞0?05）；함잡배타빈방안여함박류방안적일선화료적중위PFS분별위15?6개월화12?4개월，차이유통계학의의（ P＜0?05），이선화료적중위PFS분별위11?1개월화12?8개월，차이무통계학의의（ P＞0?05）。불량반응이혈액학독성、악심구토、수족종합증、핍력、구강궤양화복사위주；여함박류방안상비，함잡배타빈방안일선화료적1、2급악심구토발생솔교저，수족종합증발생솔교고，이이선화료적1급악심구토、핍력발생솔균교저，수족종합증발생솔교고，이상차이균유통계학의의（ P＜0?05）。결론잡배타빈여박류균대만기유선암일선、이선치료유효，잡배타빈안전내수성교호，일선치료적중위PFS경장。
Objective To explore the efficacy of capecitabine and platinum?based chemotherapy in first?line and second?line treatment of advanced breast cancer. Methods From January 2010 to June 2013, 317 patients with advanced breast cancer were en?rolled in this study. They were treated capecitabine and platinum?based chemotherapy with a cycle of 3 weeks. Tumor evaluation was performed according to RECIST 1?0 criteria and toxicities were evaluated according to NCI CTC 3?0. Patients receiving different chem?otherapy regimes were followed up and the medium progression free survival ( PFS) were compared. Results One hundred and eight?een and 78 patients can be evaluated in first?line and second?line treatment, respectively. Difference in first?line response rate ( 53?6%vs. 63?3%) and disease control rate (81?2% vs.91?8%) of capecitabine and platinum?based chemotherapy has no statistical signifi?cance (P>0?05). Similarly, no statistical significance was observed in second?line response rate (42?9% vs. 47?2%) and disease control rate ( 90?5% vs. 91?7%) between capecitabine and platinum?based chemotherapy. In first?line treatment, median progression?free survival ( PFS) of patients receiving capecitabine and platinum?based chemotherapy were 15?6 and 12?4 months with statistical significance ( P<0?05) . However, in second?line treatment, median PFS of patients receiving capecitabine and platinum?based chemo?therapy were 11?1 and 12?8 without statistical significance in difference ( P>0?05) . Adverse reactions mainly included hematological toxicity, nausea and vomiting, hand foot syndrome, asthenia, oral ulcers and diarrhea. Compared with platinum?based chemotherapy, there were lower incidence of grade 1?2 nausea and vomiting but higher incidence of hand?foot syndrome in the first?line capecitabine?based chemotherapy with statistical significance ( P<0?05) . Lower incidence of fatigue and grade 1 nausea and vomiting and higher in?cidence of hand?foot syndrome were observed in capecitabine versus platinum?based chemotherapy in second?line treatment with statisti?cal significance ( P<0?05) . Conclusion Both capecitabine and platinum are effective in the first?line and second?line treatments of advanced breast cancer. Well?tolerated patients treated with capecitabineare had a longer PFS in first?line treatment.