长春瑞滨联合顺铂治疗转移性乳腺癌

乳腺癌为严重威胁妇女身心健康的恶性肿瘤，且近年发病率有逐年上升的趋势，乳腺癌根治术后尽管联合化疗、放疗、内分泌等综合治疗，但复发转移的机率仍较高。本研究应用长春瑞滨联合顺铂治疗转移性乳腺癌23例，取得较好疗效。     

长春瑞滨加顺铂方案治疗转移性乳腺癌

目的 研究长春瑞滨（NVB）和顺铂（PDD）联合化疗方案在转移性乳腺癌治疗中的疗效和毒副反应。方法 采用NVB 25mg／m^2,快速静滴,第1、8天,PDD 25mg／m^2,静滴,第1、2、3天,每3～4周为一周期,共用2～4周期,随访6～35个月。结果 26例中完全缓解（CR）7．69％（2／26）,部分缓解（PR）38．46％（10／26）,疾病稳定（SD）30．77％（8／26）,疾病进展（PD）23．08％（6／26）。总有效率（ORR为CR＋PR）46．15％,肿瘤控制率（CR＋PR＋SD）为76．92％,中位疾病进展时间TTP为6．5个月。其中对软组织、淋巴结转移疗效较好,对内脏、骨骼转移疗效较差。毒副反应主要为白细胞减少、胃肠道反应和周围静脉炎。Ⅲ～Ⅳ度白细胞减少发牛率为46．7％,Ⅲ～Ⅳ度静脉炎的发生率为7．69％。结论 长春瑞滨加顺铂方案在转移性乳腺癌治疗中疗效较好,毒副反应可耐受。     

长春瑞滨为主联合方案治疗23例晚期乳腺癌

目前对于晚期复发乳腺癌的复治病例仍无满意的治疗方案 ,长春瑞滨 (ＮＶＢ)作为一种新型半合成的长春碱类抗癌药 ,为我们提供了一条新的途径[1 ] ,我院 ( 1998— 1999)应用以ＮＶＢ(法国ＰｉｅｒｒｅＦａｂｒｅ公司 )为主的联合化疗方案治疗Ⅳ期复发复治的乳腺癌 2 3例 ,取得较好的疗效。材料和方法一　研究对象　 2 3例均为女性 ,且全部为复治的Ⅳ期乳腺癌患者 ,均经病理或细胞学证实 ,年龄 35— 78岁 ,中位年龄 5 3岁 ,ＫＰＳ≥ 6 0分 ,预计生存期在 3月以上 ,心、肝、肾功能正常。其中以往曾做过含有蒽环类药物化疗的 14例 ,未做过含有蒽…     

长春瑞滨联合卡培他滨治疗28例转移性乳腺癌

目的：观察长春瑞滨联合卡培他滨治疗转移性乳腺癌的疗效及安全性。方法：28例有可测量病灶的转移性乳腺癌患者，中心静脉持续滴注(Civ)长春瑞滨：6mg／m^2，第1—5天，21天为一个周期，同时联合卡培他滨治疗2—4个周期。所有患者既往均接受过1种以上化疗方案的治疗，其中19例接受过蒽环类和(或)紫杉类治疗。结果：28例患者中13例接受了2个周期化疗，15例完成4个周期的化疗。CR 1例(3．57％)，PR 6例(21．43％)，MR7例(25．0％)，SD7例(25．0％)，PD7例(25．0％)，有效率达50．0％。最常见的不良反应为中性粒细胞减少、手足综合症、神经毒性、皮肤色素沉着、乏力等。结论：长春瑞滨联合卡培他滨作为二线方案治疗转移性乳腺癌的疗效确切，且不良反应可以耐受。有望成为转移性乳腺痛的理想二线化疗方案。     

长春瑞滨联合顺铂治疗32例多柔比星耐药的晚期乳腺癌

目的：观察长春瑞滨(诺维本，NVB)联合顺铂(DDP)治疗多柔比星(ADM)耐药的晚期复发、转移乳腺癌的近期疗效和毒副反应。方法：用NP方案对曾用含多柔比星联合方案治疗大于2周期后进展或复发、转移的晚期乳腺癌32例，21～28天为1周期，完成2～4周期后评价疗效。结果：总有效率62．5％，主要限量毒性为消化道反应和骨髓抑制，其次为周围神经炎。结论：NVB加DDP治疗多柔比星耐药的晚期乳腺癌仍是可供选择的有效方案，毒副反应可耐受。     

国产长春瑞滨联合阿霉素治疗转移性乳腺癌的临床观察

目的：观察国产长春瑞滨（盖诺）联合阿霉素方案治疗转移性乳腺癌的临床疗效。方法：运用国产长春瑞滨（25mg/m^2 iv dl,5)加阿霉素（40mg/m^2iv dl)治疗转移性乳腺癌28例，结果：取得CR4例，PR13例，总有效率（CR＋PR）达60．7％；主要毒副反应为白细胞减少，发生率为92．8％，其中Ⅲ-Ⅳ度骨髓抑制占64．2％，结论：国产长春瑞滨加阿霉素方案对转移性乳腺癌疗效明确，血骨髓抑制明显。     

长春瑞滨联合表阿霉素治疗乳腺癌

目的评价长春瑞滨联合表阿霉素治疗乳腺癌的疗效和毒副反应.方法多中心前瞻性临床研究.乳腺癌患者59例,应用长春瑞滨25mg/m2d1、d5静滴,表阿霉素70mg/m2d1静注,每28d为1周期,每个患者2周期.静注恩丹西酮±地塞米松预防呕吐.结果全组总缓解率(OR)69.5%,其中完全缓解率(CR)8.5%.初次化疗患者OR76.7%,CR13.3%;再次化疗患者OR62.1%,CR3.5%.乳腺原发灶OR77.4%,CR16.1%;转移灶OR61.3%,CR6.5%,其中腋窝淋巴结转移灶OR68.0%,CR8.0%;肝、肺转移灶各部分缓解(PR)50.0%.毒副反应以白细胞低下和呕吐最为常见,其发生率分别为95.8%和87.3%.其中Ⅲ°和Ⅳ°白细胞低下发生率分别高达37.3%和17.0%,Ⅲ°和Ⅳ°中性粒细胞低下的发生率分为18.6%和19.5%,32例患者需治疗性应用粒细胞集落刺激因子.Ⅲ°血小板低下和贫血的发生率分别为5.9%和2.5%.Ⅲ°脱发的发生率为14.4%,Ⅳ°便秘的发生率为0.8%.结论长春瑞滨联合表阿霉素化疗对初治与复发乳腺癌均有较高疗效,但其重度骨髓抑制发生率较高,须引起足够重视.     

长春瑞滨联合表阿霉素治疗转移性乳腺癌的临床观察

目的观察长春瑞滨（NVB）和表阿霉素（EPI）联合化疗方案在转移性乳腺癌治疗中的疗效和毒副反应。方法采用NVB25mg／m^2,第1、8天,EPI60mg／m^2第1天,每21天为一周期,共用2-4周期,随访6—36个月。结果18例24处转移灶中,完全缓解（CR）37．50％（9／24）,部分缓解（PR）16．67％（4／24）,疾病稳定（SD）37．50％（9／24）,SD≥6个月者20．83％（5／24）,疾病进展（PD）8．33％（2／24）。总有效率（CR＋PR）54．17％,临床获益率（CR＋PR＋SD≥6个月）为75．00％,中他疾病进展时间TTP为6．5个月。对锁骨上淋巴结转移的有效率最高达87．50％。不良反应主要为白细胞减少、脱发和周围静脉炎。Ⅲ-Ⅳ度白细胞减少发生率为72．22％,Ⅲ～Ⅳ度静脉炎的发生率为11．11％。结论,长春瑞滨联合表阿霉素在转移性乳腺癌治疗中疗效显著,不良反应可耐受。     

长春瑞滨联合表柔比星治疗24例晚期乳腺癌的临床研究

目的：观察和评价长春瑞滨联合表柔比星治疗晚期乳腺癌的疗效和毒副反应。方法：24例晚期乳腺癌患者接受化疗：长春瑞滨25mg／m^2，第1天，第8天；表阿霉素35mg／m^2。，第2天，第9天；28d重复，治疗两个周期以上进行疗效评价。结果：总有效率为66．7％，完全缓解率为8.3％。其中软组织部位有效率为71．4％，淋巴结为90．0％，肝脏为60．0％，胸壁为50．0％，骨骼为40．0％，肺脏为33.3％。毒副作用主要为白细胞减少和恶心呕吐。结论：长春瑞滨联合表柔比星治疗晚期乳腺癌有较高的疗效，治疗时毒副反应可以耐受。     

国产长春瑞滨联合顺铂治疗转移性乳腺癌

于 1 998年 1月至 2 0 0 1年 8月我们采用国产长春瑞滨 (商品名盖诺 )联合顺铂 (DDP)治疗转移性乳腺癌患者 4 5例 ,取得良好疗效 ,现报告如下 :1　临床资料1 .1　对象　本组 4 5例 ,均为女性 ,年龄为 30～ 6 5岁、中位年龄 4 5 0岁 ;KPS评分≥ 5 0分 ;绝经前 31人 ,绝经后 1 4人 ;均经组织学或细胞学确诊为转移性乳腺癌 ,有可测量的客观指标 ;转移部位 :肺部 2 0例、肝脏 6例、骨 1 4例、胸膜 8例、淋巴结 1 3例、软组织 1 2例、对侧乳腺 1例 ;有一个转移病灶 2 0例、两个病灶 2 3例、三个以上病灶 2例 ;有 1 6例出现转移后未曾接受任何…     

多西紫杉醇联合长春瑞滨治疗蒽环类耐药性转移性乳腺癌的疗效分析

目的：观察多西紫杉醇、长春瑞滨联合方案在对蒽环类耐药转移性乳腺癌治疗中的疗效及不良反应。方法：蒽环类耐药性转移性乳腺癌35例，予多西紫杉醇联合长春瑞滨化疗，21天为1周期，至少用2周期。用世界卫生组织的疗效和抗肿瘤药急性及亚急性毒性反应分度标准评价疗效及毒性。结果：在35例可评价疗效的患者中，完全缓解10例，部分缓解13例，有效率为65．7％，临床获益率91．4％。不良反应主要骨髓抑制、脱发、消化道反应，但均可耐受，无化疗相关死亡。结论：该方案治疗蒽环类耐药性转移性乳腺癌患者，疗效较好，不良反应可耐受。     

诺维本联合阿霉素一线治疗72例转移性乳腺癌

目的 分析72例接受诺维本加表阿霉素联合化疗方案一线治疗转移性乳腺癌患者的疗效及毒性。方法 72例未经化疗的转移性乳腺癌患者，接受诺维本25mg／m^2每周，静滴d1、d8，表阿霉素静注d1，每3周重复。结果 72例可评价疗效、毒性、生存期，完全缓解12．5％(9／72)，部分缓解65．3％(47／72)，稳定18．1％(13／72)，进展4．2％(3／72)，CR PR77．8％(56／72)。WHO血液血毒性：在360个化疗疗程中，Ⅲ和Ⅳ度粒细胞减少分别是32％和16％，Ⅲ和Ⅳ度非血液血毒性低。中位病变进展时间(TTP)为13个月(1～23月)，中位生存期为25个月(3～34月)。结论 诺维本联合表阿霉素一线治疗转移性乳腺癌疗效高、毒性低。     

Combination chemotherapy with navelbine and continuous infusion of 5-fluorouracil in metastatic, chemotherapy refractory breast cancer

Background:The protracted continuous infusion (PCI) of5-fluorouracil (5-FU) has proven in several studies an active and welltolerated treatment for advanced, pretreated breast cancer. Navelbine has alsoactivity in this setting. Patients and methods:Heavily pretreated patients with metastaticbreast carcinoma were eligible for the study. Treatment consisted of 5-FU 250mg/m² given as a PCI by an elastomeric pump and navelbine 20mg/m² on days 1 and 8, every four weeks. Eighty-three patients(median age 54 years; range 32–82 years) entered the study. The mediannumber of metastatic tumour sites was 2, with visceral involvement in 56patients. Apart from five patients with contraindications, all patients hadbeen pretreated with anthracyclines. Thirty-one patients had received taxanesand seventy-four bolus 5-FU. Results:A median of 5 cycles (range 1–14) per patient wasadministered. The median duration of 5-FU infusion was 17 weeks (range, 4-90).In the 80 evaluable patients (3 not yet evaluable) 12 complete remissions and24 partial remissions occurred (response rate, 45%). Median durationof response was 9 months. Toxicity was mild. Median survival was 20 months. Conclusions:PCI–5-FU combined with navelbine offers areasonable chance of tumour regression with modest side effects in patientswith heavily pretreated breast cancer.     

Combination chemotherapy in the treatment of advanced breast cancer

Seventy-two women with metastatic breast cancer were treated with multiple-agent chemotherapy. Fifty women were treated with 5 drugs in combination: 5-FU, methotrexate, vincristine, cytoxan, and prednisone; 22 were treated with the combination of 3 drugs: 5-FU, cytoxan, and prednisone. In 14 patients receiving 5 drugs and in 22 receiving 3 drugs, the multiple chemotherapy was the primary palliative treatment of extensive visceral metastases unsuitable for adrenalectomy. Results were similar with 6 responders in 14 (0.43) receiving 5 drugs, and 10 responders in 22 (0.45) receiving 3 drugs. The remaining 36 patients who were given 5-drug therapy all had previous adrenalectomy, and there were 16 responders (0.44). Toxicities from 3-drug treatment were substantially less severe than those from the 5-drug combination therapy. Whereas treatment-related death occurred in 6 of 50 patients receiving the 5-drug combination, no such incidence occurred in those receiving 3-drug combination therapy.     

High-dose epirubicin and cyclophosphamide every two weeks as first-line chemotherapy for relapsing metastatic breast cancer patients

Background: Metastatic breast cancer remains incurable with conventional chemotherapy. For any specific chemotherapy, higher dose intensity may be achieved with either increased doses per cycle, or shortened intervals between courses, or both. We demonstrate here the feasibility and encouraging results of a high-dose combination regimen administered every two weeks.Patients and methods: Women with metastatic breast cancer were treated every 14 days for 6 courses with 75 mg/m² epirubicin and 1200 mg/m² cyclophosphamide, followed by conventionally-delivered (q 3–4 weeks) chemotherapy. The treatment was to be resumed regardless of the neutrophil count, except in instances of febrile neutropenia. Prophylactic oral antibiotherapy was given, while hematopoietic growth factors and stem cell support were not employed.Results: Eighty-six patients were treated between May 1986 and June 1995. Their median age was 43 years (26–69). Grade 3–4 neutrophil toxicity was observed after 86% of the courses, resulting in febrile neutropenia in 5%–18% of the patients, and the rehospitalization of 5%–10%. The median given/planned dose intensity was 97% (79–106). The objective response rate in 84 evaluable patients was 54% (95% confidence interval (95% CI): 43–65), with a complete response rate of 11%, and a 14% rate of outright progression. Median progression-free survival was 16 months and median overall survival 32 months. Multivariate analysis retained previous adjuvant chemotherapy as a negative survival prognostic factor.Conclusions: This dose-intensive anthracycline-based regimen is feasible with manageable morbidity despite pronounced myelotoxicity, and yields encouraging survival rates.     

Vinorelbine and epirubicin in metastatic breast cancer. A dose finding study

The aim of the study was to define the maximum tolerated dose (MTD) of vinorelbine given as one or two weekly doses in combination with epirubicin 60 mg/m² every third week. The MTD was defined as the dose resulting in a WHO grade III or IV leucopenia exceeding 50% of patients. Patients were treated in groups of 10 at escalating doses of vinorelbine. The number of patients at the final dose level was expanded to 20. The dose of epirubicin was kept constant at 60 mg/m² every third week. At dose level 1,15 mg/m² vinorelbine was given on day 1 at level 2,20 mg/m² was given on day 1 and at level 3,20 mg/m² was given on days 1 and 8. The MTD was reached at dose level 3. WHO haematological toxicity grade IV occurred in 0, 10 and 45% and grade III at 60, 30 and 30% of patients at dose levels 1, 2 and 3, respectively. Despite the common occurrence of grade IV haematological toxicity, only two serious infections were noted. Non-haematological toxicity of vinorelbine included neurotoxicity, manifesting as muscle weakness, constipation and paresthesias in the majority of patients. Neurotoxicity was usually mild and did not require treatment discontinuation. Phlebitis at the injection site was troublesome in many patients. Alopecia and nausea, probably due to epirubicin, occurred in most patients. The response rates were 22% (95% CI (confidence interval) 3–60%), 40% (12–74%) and 60% (36–81%) at levels 1,2 and 3, respectively (nonsignificant).     

去甲长春花碱加表柔比星新辅助化疗方案治疗局部晚期乳腺癌的临床研究

目的：了解诺维本加表柔比星(表阿霉素)的联合新辅助化疗方案在局部晚期乳腺癌治疗中的疗效和毒性反应。方法：2001年9月～2003年2月，76例Ⅱb期至Ⅲb期的局部晚期乳腺癌病人入组本次临床试验。入组病例术前接受的新辅助化疗方案为：诺维本25mg／m^2，第1、8天；表阿霉素60mg/m^2，第1天，每三周为1个疗程，共3个疗程。分别观察新辅助化疗后肿瘤原发病灶和区域淋巴结的缓解情况，并观察新辅助化疗的毒性反应。结果：原发病灶临床有效率为84．2％，其中完全缓解(CR)19．7％，部分缓解(PR)64．5％，疾病稳定(SD)14．5％，疾病进展(PD)1．3％；病理完全缓解率为14．5％(11／76)。32例化疗前细针穿刺活检明确区域淋巴结转移阳性的病人中，9例(28．1％)术后病理腋淋巴结转移阴性。毒性反应主要为白细胞减少症、脱发和恶心／呕吐，共有39例(54．2％)病人发生了Ⅲ到Ⅳ度的白细胞减少症，但未有因此而发生的败血症和死亡病例。结论：诺维本加表阿霉素的新辅助化疗方案在局部晚期乳腺癌的治疗中疗效显著，耐受性良好。     

Efficiency and safety of trastuzumab plus chemotherapy in Her-2 overexpressing metastatic breast cancer patients

Objective： The aim of this study was to evaluate the safety and efficiency of combination of trastuzumab and chemotherapy as first line regimen in Her-2 overexpressing metastatic breast cancer （MBC） patients. The primary endpoint was overall response rate （ORR） and the second endpoint was clinical benefit rate （CBR） and toxcities. Methods： Estrogen recep- tor （ER） （-）, progesterone receptor （PR） （-）, Her-2 （＋＋＋） patients were included in the study. 126 eligible patients were divided into 2 groups, 51 of them were assigned to the Herceptin group （H group） and 75 of them were assigned to the Control group （C group）. They were treated by commonly used chemotherapy regimens with or without trastuzumab. Results： Response rate （RR） of the H group and the C group were 51.0% and 24.0% separately, and the difference were statistically significant （P 〈 0.05）. CBR of the two groups were 76.4% （H group） and 64.0% （C group）, had significant difference （P 〈 0.05）. Complete response rate （CRR） of the two groups were 21.5% and 6.6%, there were no significant difference between the two groups （P = 0.055）. Grade 3-4 cardiac toxicity were recorded in 9 patients with trastuzumab plus chemotherapy （17.6%） and 4 patients with chemotherapy （5.4%）, with no statistical significance （P = 0.054）. In the subgroup of antharcycline-containing regimens, Grade 1-4 cardiac toxicity occurred in 9 patients in the trasutuzumab combining with antharcycline-containing regimens arm [herceptin plus anthracyciine contained chemotherapy （H ＋ ACCT arm; 40.9%, g/22）], and 4 patients in the antharcycline- containing chemotherapy arm （ACCT arm; 12.5%, 4/32）. There was statistical significant difference between the two arms （P 〈 0.05）. Grade 3--4 cardiac toxicity, the occurance rates were 18.1% （4/22） in H ＋ ACCT arm and 6.3% （2/32） in ACCT arm, and there was no significant statistical difference （P = 0.352）. Grade 3-4 granulocytopenia     

以紫杉醇为主的联合化疗方案治疗转移性乳腺癌的临床研究

目的观察以紫杉醇为主的联合化疗方案治疗转移性乳腺癌的近期疗效和不良反应。方法既往未用过蒽环类化疗者选用TE方案:表阿霉素70~80mg/m2,静滴,第1天,紫杉醇135~175mg/m2,静滴,第2天。既往用过蒽环类化疗者选用TP方案:紫杉醇135~175mg/m2,静滴,第1天,DDP80mg/m2,静滴,分三天用(第2、3、4天)。21~28天为一周期,至少治疗2周期。中位化疗周期数3个(2~6周期)。结果全组70例,CR7例(10.0%),PR36例(51.4%),SD24例(34.3%),PD3例(4.3%),总有效率61.4%。TE方案有效率61.2%,TP方案有效率62.8%。中位肿瘤进展时间TTP9.8个月,中位生存期17.5个月。主要不良反应为骨髓抑制和消化道反应。结论以紫杉醇为主的联合化疗方案对转移性乳腺癌有较好的疗效,毒副反应能忍受,对蒽环类耐药及对铂类抗药的晚期乳腺癌也有很好的疗效。