CAJ | 학술논문

长春瑞滨为基础的联合化疗用于蒽环类和紫杉类药物失败后晚期三阴性乳腺癌的疗效及安全性
장춘서빈위기출적연합화료용우은배류화자삼류약물실패후만기삼음성유선암적료효급안전성
Efficacy and toxicity of vinorelbine(NVB)-based regimens in patients with metastatic triple negative breast cancer(mTNBC)pretreated with anthracyclines and taxanes

万方数据

中华肿瘤杂志中華腫瘤雜誌 중화종류잡지
Chinese Journal of Oncology
2015年 10期 788-792 ,共5页

杜丰%袁芃%罗杨%王佳玉%马飞%蔡锐刚%樊英%李青%张频%徐兵河

두봉%원봉%라양%왕가옥%마비%채예강%번영%리청%장빈%서병하

乳腺肿瘤%抗肿瘤联合化疗方案%长春瑞滨%顺铂%卡培他滨乳腺腫瘤%抗腫瘤聯閤化療方案%長春瑞濱%順鉑%卡培他濱
유선종류%항종류연합화료방안%장춘서빈%순박%잡배타빈
Breast neoplasms%Antineoplastic combined chemotherapy protocols%Platinum%Vinorelbine%Capecitabine

目的：评价含长春瑞滨联合化疗方案用于蒽环类和紫杉类药物治疗失败后晚期三阴性乳腺癌患者的疗效及安全性。方法回顾性分析2004年1月至2012年12月收治的48例晚期三阴性乳腺癌患者的临床资料。入组条件包括有可评价的转移病灶；既往在新辅助、辅助或晚期化疗阶段应用过蒽环类和至少1种紫杉类药物。48例患者中，一线化疗21例，二线化疗27例。治疗方案为NP方案（长春瑞滨联合铂类）22例，NX方案（长春瑞滨联合卡培他滨）26例。结果全组患者的客观有效率为20．8％，临床获益率为43．8％，无进展生存时间（ PFS）为4．4个月，总生存时间（ OS）为15．5个月。 NP方案患者的有效率为33．8％，高于NX方案（7．7％），差异有统计学意义（P＝0．029）；NP方案患者的PFS为5．3个月，高于NX方案（3．0个月），差异有统计学意义（P＝0．023）；NP方案患者的OS（27．7个月）与NX方案患者（14．8个月）比较，差异无统计学意义（P＝0．077）。全组患者常见的不良反应为1～2级胃肠道反应（68．8％）、中性粒细胞下降（62．5％）；NX组与NP 组患者不良反应的发生率比较，差异均无统计学意义（均P＞0．05）。 NP组和NX组分别有2例和1例患者出现用药延迟。结论含长春瑞滨联合方案治疗蒽环类和紫杉类药物耐药的晚期三阴性乳腺癌疗效和安全性较好， NP方案的疗效可能优于NX方案，但需开展随机Ⅲ期临床研究进一步验证。
목적：평개함장춘서빈연합화료방안용우은배류화자삼류약물치료실패후만기삼음성유선암환자적료효급안전성。방법회고성분석2004년1월지2012년12월수치적48례만기삼음성유선암환자적림상자료。입조조건포괄유가평개적전이병조；기왕재신보조、보조혹만기화료계단응용과은배류화지소1충자삼류약물。48례환자중，일선화료21례，이선화료27례。치료방안위NP방안（장춘서빈연합박류）22례，NX방안（장춘서빈연합잡배타빈）26례。결과전조환자적객관유효솔위20．8％，림상획익솔위43．8％，무진전생존시간（ PFS）위4．4개월，총생존시간（ OS）위15．5개월。 NP방안환자적유효솔위33．8％，고우NX방안（7．7％），차이유통계학의의（P＝0．029）；NP방안환자적PFS위5．3개월，고우NX방안（3．0개월），차이유통계학의의（P＝0．023）；NP방안환자적OS（27．7개월）여NX방안환자（14．8개월）비교，차이무통계학의의（P＝0．077）。전조환자상견적불량반응위1～2급위장도반응（68．8％）、중성립세포하강（62．5％）；NX조여NP 조환자불량반응적발생솔비교，차이균무통계학의의（균P＞0．05）。 NP조화NX조분별유2례화1례환자출현용약연지。결론함장춘서빈연합방안치료은배류화자삼류약물내약적만기삼음성유선암료효화안전성교호， NP방안적료효가능우우NX방안，단수개전수궤Ⅲ기림상연구진일보험증。
Objective To assess the efficacy of vinorelbine ( NVB)?based regimens in patients with metastatic triple negative breast cancer (mTNBC) pretreated with anthracyclines and taxanes. Methods Clinical data of 48 patients diagnosed and treated for mTNBC between 2004 and 2012 at the Cancer Hospital, Chinese Academy of Medical Sciences ( CAMS) were retrospectively analyzed. All patients were pretreated with anthracyclines and at least one taxane in neo?adjuvant, adjuvant or chemotherapy for mTNBC and patients should be having at least one measurable metastatic lesion. Totally, 48 patients were included in this study, of which 21 cases received first?line chemotherapy and 27 cases received second?line chemotherapy. Based on the regimen they received, 22 patients were treated with NVB plus platinum ( NP ) , and 26 patients with NVB plus capecitabine ( NX ) . Results After 70 months follow?up, in the total group of patients, the objective response rate was 20.8%, clinical benefit rate was 43.8%, median progression free survival (PFS) was 4.4 months and median overall survival (OS) was 15.5 months. In addition, the ORR was significantly better in the NP arm versus NX arm (33.8% vs.7.7%, P=0.029) as well as PFS was statistically improved in the NP arm than NX arm (5.3 m vs. 3.0 m, P=0.023). Similar trend was observed in the OS, although the difference was not statistically significant (27.7 m vs. 14.8 m, P=0.077). In all, the most frequently reported adverse events were G1/2 gastrointestinal toxicity ( 68. 8%) and neutropenia (62.5%) . No significant difference was observed between the NP arm and NX arm ( P>0. 05). The percentage of patients who delayed chemotherapy administration in the NP arm and NX arm was 9.1% ( n= <br> 2), and 3.8% (n=1), respectively. Conclusions NVB?based combination chemotherapy demonstrates moderate efficacy in mTNBC patients pretreated with anthracyclines and one taxane with manageable toxicity. NP regimen shows potential superiority over NX regimen, and should be further verified in randomized phaseⅢ clinical trial in larger cohort.