Combination of Calcium Folinate and 5-Fluorouracil As Second-line Treatment for Advanced Breast Cancer
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摘要: 目的 观察甲酰四氢叶酸钙（CF）联合5-氟尿嘧啶（5-Fu）治疗晚期乳腺癌的疗效和安全性。方法选择既往经过蒽环类、紫杉类等药物治疗无效的晚期乳腺癌31例，中位年龄48.0岁（27～66岁）。采用CF联合5-Fu化疗方案治疗。CF［150 mg/(m２·d)］＋5-Fu ［600 mg/(m２·d)］，连用5天，每天静脉滴注不少于12 h，每4周为一周期。观察有效率及不良反应。结果完全缓解2例（6.5%），部分缓解7例（22.6%），病情稳定6例（19.4%），进展16例（51.6%）。总有效率为29.0%，临床获益率为48.4%，其中激素受体阴性患者更能获益(P<0.05)。中位有效期为2.3月（95%CI：1.1～4.1），中位生存期为9.5月（95%CI：4.7～14.8）。15例(48.4%)生活质量改善，6例(19.4%)稳定，10例(32.3%)下降。不良反应主要是胃肠道反应（11例）、骨髓抑制（4例）和口腔炎（9例）。结论CF＋5-Fu联合静脉滴注二线治疗晚期乳腺癌疗效确切，不良反应可控，患者易于耐受，可以作为复发转移的晚期难治性乳腺癌的解救治疗。Abstract: Objective To study the clinical efficiency and safety of calcium folinate combined with 5-fluorouracil in advanced breast cancer patients. Methods Thirty-one advanced breast cancer patients were enrolled，with median age was 48.0 years (27~66 years), who had progressed diseases after treatments of anthracycline compounds and paclitaxel.Estrogen receptor(ER) and (or) progesterone receptor(PR) were positive in 12 cases(ER+,9 cases;PR+,5 cases;ER+ and PR+,2 cases),ER and PR were negative in 19 cases.The patients were treated with CF［150 mg/(m2·d)］ and 5-Fu［(600 mg/(m2·d)］ by venous infusion for more than 12 hours with D1~5.This therapeutic regimen was 28 days per 1 cycle. Results Complete response(CR),partial response(PR),stable disease (SD) and progressive disease (PD) was achieved in 2 patients (6.4%),7 patients(22.58%),6 patients(19.35%) and 16 patients(51.61%),respectively.Overall response rate(CR+PR) was 29.0% and the clinical benefit rate(CR+PR+SD) was 48.4%.It was more obvious that patients with negative hormone receptor had increased response rate(P<0.05).The median duration of response was 2.3 months（95% CI:1.1~4.1） and median survival time was 9.5 months（95%CI:4.7~14.8）.The quality of life was improved in 15 cases(48.4%),stable in 6 cases(19.4%) and decreased in 10 cases(32.3%).The main toxic effects were gastrointestinal side-effect (11 cases),bone marrow suppression(4 cases) and stomatitis(9 cases). Conclusion The combination of CF and 5-Fu given by continuous venous infusion every 4 weeks was active in terms of objective response rate against advanced breast cancer with well-tolerance.
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Key words:
- Advanced breast cancer /
- Calcium folinate /
- 5-fluorouracil
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