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甲酰四氢叶酸钙联合5-氟尿嘧啶二线治疗晚期乳腺癌

Combination of Calcium Folinate and 5-Fluorouracil As Second-line Treatment for Advanced Breast Cancer

  • 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/(m·d)]+5-Fu [600 mg/(m·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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