乳腺肿瘤%药物疗法,联合%预后%卡培他滨
乳腺腫瘤%藥物療法,聯閤%預後%卡培他濱
유선종류%약물요법,연합%예후%잡배타빈
Breast neoplasms%Drug therapy,combination%Prognosis%Capecitabine
目的 评价复发转移乳腺癌联合化疗后未进展患者卡培他滨维持治疗的PFS和安全性及其预后影响因素.方法 收集2011年1月-2013年6月在兰州大学第一医院肿瘤内科治疗的复发转移乳腺癌患者38例,给予长春瑞滨联合卡培他滨化疗,未进展患者给予单药卡培他滨口服维持治疗,每日2次,2000 mg·m-2·d-1,连续服用14 d后停药7d,治疗周期21 d,至少治疗2个周期,直至PD或不良反应不能耐受.观察并记录不良反应及PFS.采用x2检验和多因素COX风险比例模型分析患者临床特征与总有效率和PFS的关系.结果 38例患者中CR 4例,PR 17例,SD 11例,PD 6例,总有效率55.26％(21/38).32例(84.21％)临床获益患者(CR+ PR+ SD)给予卡培他滨单药维持治疗至PD,中位PFS为10.0个月.Karnofsky功能状态(KPS)评分≥80分的患者PFS为14.1个月,＜80分的患者PFS为6.8个月,两组差异有统计学意义(x2=6.251,P=0.000).多因素COX风险比例模型分析显示,患者年龄(RR=3.561,95％CI:1.372～5.216,x2=4.025,P=0.031)、绝经状态(RR=1.895,95％CI:1.124 ～4.452,x2 =5.725,P=0.048)、KPS评分(RR=4.553,95％CI:1.131 ～7.703,x2=11.205,P=0.005)、肿瘤转移数目(RR =5.781,95％CI:2.321～11.243,x2=3.925,P=0.011)是患者重要的预后影响因素.主要不良反应为Ⅰ～Ⅱ级手足综合征,1例重度手足综合征患者2周期后停止卡培他滨的治疗.结论 复发转移性乳腺癌患者联合化疗达到缓解或稳定后给予卡培他滨维持化疗,可显著延长患者PFS,且耐受性良好,患者年龄、绝经状态、KPS评分、肿瘤转移数目可作为该联合方案后维持化疗的预后影响因素.
目的 評價複髮轉移乳腺癌聯閤化療後未進展患者卡培他濱維持治療的PFS和安全性及其預後影響因素.方法 收集2011年1月-2013年6月在蘭州大學第一醫院腫瘤內科治療的複髮轉移乳腺癌患者38例,給予長春瑞濱聯閤卡培他濱化療,未進展患者給予單藥卡培他濱口服維持治療,每日2次,2000 mg·m-2·d-1,連續服用14 d後停藥7d,治療週期21 d,至少治療2箇週期,直至PD或不良反應不能耐受.觀察併記錄不良反應及PFS.採用x2檢驗和多因素COX風險比例模型分析患者臨床特徵與總有效率和PFS的關繫.結果 38例患者中CR 4例,PR 17例,SD 11例,PD 6例,總有效率55.26％(21/38).32例(84.21％)臨床穫益患者(CR+ PR+ SD)給予卡培他濱單藥維持治療至PD,中位PFS為10.0箇月.Karnofsky功能狀態(KPS)評分≥80分的患者PFS為14.1箇月,＜80分的患者PFS為6.8箇月,兩組差異有統計學意義(x2=6.251,P=0.000).多因素COX風險比例模型分析顯示,患者年齡(RR=3.561,95％CI:1.372～5.216,x2=4.025,P=0.031)、絕經狀態(RR=1.895,95％CI:1.124 ～4.452,x2 =5.725,P=0.048)、KPS評分(RR=4.553,95％CI:1.131 ～7.703,x2=11.205,P=0.005)、腫瘤轉移數目(RR =5.781,95％CI:2.321～11.243,x2=3.925,P=0.011)是患者重要的預後影響因素.主要不良反應為Ⅰ～Ⅱ級手足綜閤徵,1例重度手足綜閤徵患者2週期後停止卡培他濱的治療.結論 複髮轉移性乳腺癌患者聯閤化療達到緩解或穩定後給予卡培他濱維持化療,可顯著延長患者PFS,且耐受性良好,患者年齡、絕經狀態、KPS評分、腫瘤轉移數目可作為該聯閤方案後維持化療的預後影響因素.
목적 평개복발전이유선암연합화료후미진전환자잡배타빈유지치료적PFS화안전성급기예후영향인소.방법 수집2011년1월-2013년6월재란주대학제일의원종류내과치료적복발전이유선암환자38례,급여장춘서빈연합잡배타빈화료,미진전환자급여단약잡배타빈구복유지치료,매일2차,2000 mg·m-2·d-1,련속복용14 d후정약7d,치료주기21 d,지소치료2개주기,직지PD혹불량반응불능내수.관찰병기록불량반응급PFS.채용x2검험화다인소COX풍험비례모형분석환자림상특정여총유효솔화PFS적관계.결과 38례환자중CR 4례,PR 17례,SD 11례,PD 6례,총유효솔55.26％(21/38).32례(84.21％)림상획익환자(CR+ PR+ SD)급여잡배타빈단약유지치료지PD,중위PFS위10.0개월.Karnofsky공능상태(KPS)평분≥80분적환자PFS위14.1개월,＜80분적환자PFS위6.8개월,량조차이유통계학의의(x2=6.251,P=0.000).다인소COX풍험비례모형분석현시,환자년령(RR=3.561,95％CI:1.372～5.216,x2=4.025,P=0.031)、절경상태(RR=1.895,95％CI:1.124 ～4.452,x2 =5.725,P=0.048)、KPS평분(RR=4.553,95％CI:1.131 ～7.703,x2=11.205,P=0.005)、종류전이수목(RR =5.781,95％CI:2.321～11.243,x2=3.925,P=0.011)시환자중요적예후영향인소.주요불량반응위Ⅰ～Ⅱ급수족종합정,1례중도수족종합정환자2주기후정지잡배타빈적치료.결론 복발전이성유선암환자연합화료체도완해혹은정후급여잡배타빈유지화료,가현저연장환자PFS,차내수성량호,환자년령、절경상태、KPS평분、종류전이수목가작위해연합방안후유지화료적예후영향인소.
Objective To investigate the therapeutic effect,safety and its prognostic factors of capecitabine as maintenance treatment agent for prolonging the PFS of patients with recurrent and metastatic breast cancer after they received combination chemotherapy.Methods From January 2011 to June 2013,38 cases with recurrent and metastatic breast cancer were collected in the department of medical oncology of the First Hospital of Lanzhou University.All the 38 patients received NX scheme (vinorelbine combined capecitabine chemotherapy),and some patients among of them had stabile disease after chemotherapy and were administered X scheme (capecitabine,twice a day,2 000 mg/m2 daily,withdrawal for 7 days after a consecutive intake of 14 days,21 days as a cycle,at least 2 cycles) until disease progressed or toxicity could not be tolerated.Adverse reactions and PFS were observed and recorded.Single factor chi square test and multivariate COX proportion hazard model were used to evaluate the relationships between clinic features and RR,PFS.Results The overall response rate (CR + PR) was 55.26％ (21/38),clinical benefit patients rate (CR + PR + SD) was 84.2％ (32/38),with 4 patients of CR (4/32),17 patients of PR,11 patients of SD,6 patients of PD.Thirty-two no progressived patients were administered capecitabine until PD.The median PFS was 10.0 months.Stratification analysis showed that patients whose Karnofsky (KPS) ≥80 had an average PFS of 14.1 months,while an average PFS of 6.8 months for patients whose KPS ＜ 80,with a statistical significance (x2 =6.251,P =0.000).Cox proportion hazard model also showed that age (RR =3.561,95％ CI:1.372-5.216,.x2 =4.025,P =0.031),menopausal status (RR =1.895,95 ％ CI:1.124-4.452,x2 =5.725,P =0.048),KPS score (RR =4.553,95％ CI:1.131-7.703,x2 =11.205,P =0.005),the number of metastasis (RR =5.781,95％ CI:2.321 ～11.243,x2 =3.925,P =0.011) were important prognostic factors for the patients with breast cancer.Major treatment-related adverse reaction was grade Ⅰ-Ⅱ hand-foot syndrome.One patient discontinued treatment because of grade Ⅲ hand-foot syndrome.Conclusion Capecitabine as maintenance treatment can significantly prolong the PFS of patients with recurrent and metastatic breast cancers at remission or stable stage after combination chemotherapy with a better tolerance.Age of patients,menopausal status,KPS score,the number of metastasis are the prognostic factors for the efficacy of NX-X regimen.
