吉西他滨联合卡培他滨治疗晚期乳腺癌的疗效观察

目的：观察吉西他滨联合卡培他滨治疗晚期乳腺癌的临床疗效和不良反应。方法：吉西他滨1000mg/m2,1、8d;卡培他滨2500mg/（m2·d）,分2次口服,第1～14天,21d为1个周期。所有患者均接受至少2个周期的化疗。结果：48例患者入组均可评价疗效,CR率为12.5%（6/48）,PR率为29.2%（14/48）,SD率为20.8%（10/48）,PD率为37.5%（18/48）。有效率为41.7%（20/48）,临床获益率为62.5%（30/48）。中位随访期10个月,中位TTP7个月,中位OS9.5个月,1年生存率为66.7%。主要不良反应为骨髓毒性及手足综合征,Ⅲ度及Ⅳ度白细胞减少为22.9%（11/48）,Ⅲ度及Ⅳ度血小板减少为18.8%（9/48）。手足综合征发生率为70.8%,其中,Ⅲ度及Ⅳ度手足综合征发生率为16.7%（8/48）。结论：吉西他滨联合卡培他滨方案治疗蒽环类和紫杉类化疗失败的转移性乳腺癌有较好的疗效,患者耐受性好,值得临床进一步研究。

Clinical experience of gemcitabine combined with capecitabine in treating patients with advanced metastatic breast cancer

Objective：To observe the efficacy and toxicity of the combination of gemcitabine and capecitabine in the treatment of anthracycline and taxane-resistant advanced metastatic breast cancer（MBC） patients.Methods：48 patients with advanced MBC failed to previous chemotherapy with anthracycline and taxane were enrolled into the study.The patients received gemcitabine 1 000 mg/m2 on days 1,8,and capecitabine 2 500 mg/（m2·d）,bid,on day 1-14,with 21 days as a cycle.Each patient received at least two cycles.Results：Of the 48 patients,6 cases got complete response,14 cases got partial response,10 cases had stable disease,and 18 cases had progressive disease,with the overall response rate was 41.7%（20/48）,the clinical benefit rate was 62.5%（30/48）.With a median follow-up of 10 months.The median TTP was 7 months.The median OS was 9.5 months.The 1 year survival rate was 66.7%.The main toxic reactions were myelosuppression and hand-foot syndrome,leukopenia（incidence of 22.9% for gradeⅢ＋Ⅳ） and hand-foot syndrome（incidence of 70.8%,incidence of 16.7% for gradeⅢ＋Ⅳ）.Conclusion：The combination of gemcitabine and capecitabine is active in the treatment of anthracycline and taxane-resistant advanced MBC with acceptable toxicity,and may be an effective salvage therapy.