目的

分析紫杉醇单药每周方案治疗老年转移性乳腺癌的疗效及安全性。

方法

本科于2004年至2007年间收治了33例经病理证实的晚期转移性乳腺癌患者,年龄65～74岁,中位年龄68岁,复发转移后初治的19例患者为一线治疗组,既往接受其他化疗的14例患者为二线治疗组,两组均接受紫杉醇单药治疗80 mg/m²,第1、8、15天应用,28 d为1个周期。应用紫杉醇前常规采用地塞米松、苯海拉明、西咪替丁等抗过敏处理。应用SPSS10.0统计软件进行统计学处理,采用Fisher检验比较组间的疗效和生存情况。

结果

可评价疗效病例33例,总有效率为39%,其中完全缓解(co mplete response,CR)1例(3%),部分缓解(partial response,PR)12例(36%),稳定(stable disease,SD)9例(27%)、进展(pr ogressing disease,PD)11例(33%)。一线治疗组CR 1例,PR 7例;二线治疗组CR 0例,PR 5例,两组疗效差异无统计学意义(χ²=0.13,P=0.26)。中位化疗周期为6个,临床受益(CR+PR+SD)22例(67%),中位肿瘤进展时间(TTP)为5.8个月,中位总生存时间(OS)是16.1个月。不良反应主要为骨髓抑制和神经肌肉毒性,毒性反应分级为Ⅰ～Ⅱ度,未见严重不良反应。

结论

对于老年转移性乳腺癌患者,单药紫杉醇每周方案疗效是肯定的,耐受性良好,极少引起严重的血液学及非血液学毒性,对于一般情况差的老年患者仍然有效。

Objective

To eval uate t he efficacy and toxicity of weekly palitaxel therapy for elderly metastatic breast cancer patients.

Methods

Fro m 2004 to 2007,33 patients,aged≥65 years(median age 68 years),with advanced metastatic breast cancer were ad mitted and treated in our depart ment.All patients were confir med pat hologicall y.Among the m,patients receiving initial paclitaxel t herapy after recurrence and metastasis were taken as t he first line t herapy gr oup(n=19),and patients who had received ot her che mot herapy bef ore were taken as t he second line t herapy gr oup.All patients were given paclitaxel at a dose of 80 mg/m² weekly on days 1,8 and 15 of a 28-day cycle.Pre medications consisted of diphenhydra mine,ci metidene and dexa met hasone.SPSS10.0 was used f or stastistcal analysis.Co mparison of efficacy,adverse effect and overall sur vival bet ween t he t wo groups was perf or med using Chi-square test.P ＜0.05 was considered statistically significant.

Results

All t he 33 patients were eval uable.The overall response rate(ORR)was 39%(13/33).Co mplete response(CR)was in one patient(3%),partial response(PC)in 12(12%),stable disease(SD)in 9(27%),and progressing disease(PD)in 11(33%).In the first line therapy group CR was in 1 case and PRin 7 cases;in the second line therapy group 5 cases obtained PR,with no statistical difference bet ween the t wo groups(P=0.26).The median chemotherapy cycle was 6 cycles.Twenty-t wo patients (67% )had clinical benefit.The median TTP (ti me to pr ogression)was 5.8 mont hs,and t he median overall sur vival(OS)was 16.1 mont hs.The adverse effect was mainl y myel osuppression and toxicit yin neuro muscle.Grade I-II toxicity was neutr openia and neur opathy.

Conclusion

For el derly metastatic breast cancer patients,paclitaxel as a single agent t herapy given weekly is eff ective and well tolerated.I mportantly,this regi men causes a low incidence of severe hematologic and non-he matologic toxicities.And it is also effective in t he treat ment of el derl y and poor perf or mance stat us patients wit h metastatic breast cancer.