目的

观察卡培他滨联合多西紫杉醇治疗蒽环类耐药的晚期乳腺癌的疗效与安全性。

方法

于2001 年9 月至2005 年5 月，41 例蒽环类耐药的晚期乳腺癌患者实施了卡培他滨联合多西紫杉醇方案化疗，卡培他滨1000～1250 mg/m² 口服，每日2次，第1～14天；多西紫杉醇60～75 mg/m²，静滴，第1天或30～37.5 mg/m²，静滴，第1、8天；21 d为1周期。 每例至少治疗2周期后评价疗效，中位化疗周期数为4（2～8）周期。

结果

在38 例可评价疗效的患者中，完全缓解（CR）4 例（10.5% ） ，部分缓解（PR）18 例（47.4% ），稳定（SD）11 例（28.9% ），进展（PD）5 例（13.2% ），总有效率（CR+PR）为57.9% ，疾病控制率（CR+PR+SD）为86.8% ，中位肿瘤进展时间（TTP）9.1 个月，中位生存期18.4 个月。 主要毒性反应为骨髓抑制和胃肠道反应。

结论

卡培他滨和多西紫杉醇联合方案治疗蒽环类耐药的转移性乳腺癌疗效好，使用方便，耐受性良好，适合于体质状态稍差的老年患者，可作为蒽环类耐药的晚期乳腺癌的有效解救治疗方案。

Objective

To evaluate the efficacy and safety of oral capecitabine in combination with docetaxel for patients with anthracycline-resistant advanced breast carcinoma.

Methods

Forty-one patients with anthracyclineresistant advanced breast cancer received oral capecitabine 1000-1250 mg/m² twice daily，days 1-14，plus i.v.docetaxel 60-75 mg/m² on day 1 or 30-37.5 mg/m² on days 1 and 8 of each 21 day treatment cycle.Every patient was administered at least 2 cycles and with a median of 4 cycles （2-8 cycles）.

Results

All 41 patients were evaluable for safety and 38 for efficacy.The overall combination chemotherapy objective response rate was 57.9% including complete responses（CR）in 4（10.5%） patients，paritical responses（PR）in 18（47.4%） patients，stable disease （SD） in 11 （28.9%） patients， and progressive disease （PD） in 5 （13.2%） patients.Disease control rate（CR+PR+SD）was 86.8%.The median time to disease progression or TTP was 9.1 months.The main side effects were hematologic and gastrointestinal toxicities including grade 3-4 leukopenia in 5 patients （12.2% ）and nausea and vomiting in 1 patient.

Conclusions

Capecitabine and docetaxel combination regimen has important antitumor activity in the treatment of anthracyclin-resistant advanced breast cancer patients，with an acceptable safety profile in this setting， especially for older patients.It may be regarded as the salvage chemotherapy afte r anthracycline regimen has failed.