盖诺联合顺铂对晚期乳腺癌治疗体会

CHINESE COMMUNITY DOCTORS 当前临床针对晚期乳腺癌多采用化疗方式，达到控制病情、缩小病灶的目的，进而延长患者生存时间。含蒽环类药物化疗效果显著，但仍有约20%～30%的患者会发生心脏毒性反应和耐药性，临床需探寻价格适宜、低毒、高效的二线化疗方式[1]。盖诺为治疗晚期乳腺癌的有效药物，联用顺铂可发挥协同效果，且不会与其他化疗药物发生交叉耐药性。已有报告证实[2]，盖诺联合顺铂治疗晚期乳腺癌，安全高效。本研究纳入我院收治的晚期乳腺癌患者64例分组论述盖诺联合顺铂治疗效果，现报告如下。资料与方法2019年4月-2020年1月收治晚期乳腺癌患者64例，随机分为两组，各32例。所有患者均符合《中国抗癌协会乳腺癌诊治指南与规范(2017年版)》中乳腺癌判定标准[3]；均接受蒽环类药物治疗无效或失败，均签署知情同意书；排除预估生存时间＜3个月，合并其他原发肿瘤。对照组患者年龄41～68岁，平均(53.62±2.35)岁；病程3～28个月，平均(12.35±1.65)个月；病理类型：管状癌5例，髓样癌8例，小叶浸润癌9例，导管浸润癌10例，其他2例；病灶转移状况：胸膜转移9例，骨转移7例，肝转移5例，肺转移4例；KPS 评分为60～89分，平均(74.50±1.32)分。观察组患者年龄41～69岁，平均(53.85±2.34)岁；病程3～28.30个月，平均(12.36±1.64)个月；病理类型：管状癌5例，髓样癌7例，小叶浸润癌11例，导管浸润癌9例，其他2例；病灶转移状况：胸膜转移8例，骨转移6例，肝转移4例，肺转移5例；KPS 评分为61～89分，平均(74.53±1.29)分。两组一般资料比较，差异无统计学意义(P ＞0.05)，具有可比性。

方法：①对照组接受多西他赛联合

顺铂治疗：第1天，静脉滴注75mg/m 2多

西他赛和75mg/m 2顺铂，并辅以利尿、止吐等干预。②观察组接受盖诺联合顺铂治疗：第1～3天，静脉滴注30mg/m 2顺铂，1周期为3周；第1～8天，静脉快

doi:10.3969/j.issn.1007-614x.2021.09.022

摘要目的：分析盖诺联合顺铂治疗晚期乳腺癌的临床效果。方法：2019年4月-2020年1月收治晚期乳腺癌患者

64例，随机分为两组，各32例。对照组给予多西他赛联合顺铂治疗，观察组给予盖诺联合顺铂治疗，比较两组治疗

效果。结果：观察组治疗总有效率及生存率均高于对照组，且不良反应发生率低于对照组，差异有统计学意义(P ＜

0.05)；观察组治疗后糖类抗原125(CA125)、癌胚抗原(CEA)、胰岛素样生长因子-1(IGF-1)等指标水平均显著低于对

照组，差异有统计学意义(P ＜0.05)。结论：临床可采用盖诺联合顺铂治疗晚期乳腺癌，患者近期疗效理想，生存率得

到提高，抗肿瘤效果理想。

关键词晚期乳腺癌；盖诺；顺铂；疗效

Treatment experience of vinorelbine tartrate combined with cisplatin in the treatment of advanced breast cancer

Luo Pan,Xiao Jia,Fang Jianlong,Zhou Qiang(Corresponding author)

Yueyang First People's Hospital Oncology,Yueyang,Hunan 414000

Abstract Objective:To analyze the clinical effect of vinorelbine tartrate combined with cisplatin in the treatment of advanced

breast cancer.Methods:From April 2019to January 2020,64cases of patients with advanced breast cancer were enrolled,they were

randomly divided into two groups with 32cases in each group.The control group was treated with docetaxel and cisplatin.The

observation group was treated with vinorelbine tartrate combined with cisplatin.The therapeutic effects between the two groups

was compared.Results:The total effective rate of treatment and survival rate in the observation group were higher than those in the

control group,while the incidence of adverse reactions was lower than that of control group,the differences were statistically

significant(P ＜0.05).The levels of carbohydrate antigen 125(CA125),carcinoembryonic antigen(CEA)and insulin-like growth

factor-1(IGF-1)in the observation group were significantly lower than those in the control group after treatment,the differences

were statistically significant(P ＜0.05).Conclusion:Vinorelbine tartrate combined with cisplatin can be used in the clinical

treatment of advanced breast cancer,after treatment,the short-term curative effect is ideal,the survival rate is improved and the

anti-tumor effect is ideal.

Key words Advanced breast cancer;Vinorelbine tartrate;Cisplatin;Efficacy

盖诺联合顺铂对晚期乳腺癌治疗体会

罗盘肖佳方建龙周强(通信作者)

414000岳阳市一人民医院肿瘤科，湖南

岳阳

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