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目的观察应用吉西他滨联合顺铂的方法治疗蒽环类及紫杉类耐药的转移性三阴乳腺癌(雌激素受体、孕激素受体、表皮生长因子受体2阴性)患者的一般疗效及毒副反应。方法 2011年12月至2013年12月收治的26例转移性三阴乳腺癌患者,均为一线、二线选用过蒽环类及/或紫杉类药物化疗,治疗期间病情进展,或初始治疗有效但6个月内复发或进展者。本次入院后采用吉西他滨联合顺铂联合化疗。用药方法:吉西他滨1 000 mg/m2d1、d8静脉滴注;顺铂80 mg/m2分3~4 d静脉滴注。21 d为1个周期,每2个周期评估疗效。结果 26例患者均接受了至少2个周期的化疗;其中单个部位转移的患者治疗有效率为66.67%,多个部位转移患者的治疗有效率为38.46%;患者存在Ⅰ~Ⅳ度的不同毒副反应,包括骨髓抑制、恶心呕吐、脱发等;给予粒细胞集落刺激因子、白介素-11应用后均可逐渐缓解,未见合并致死性感染或出血现象。结论吉西他滨联合顺铂方案有较高的疾病控制率,不良反应以白细胞、血小板减低及恶心、呕吐较为常见,但患者均可耐受,故其可作为蒽环类及紫杉类均耐药的转移性三阴乳腺癌可选化疗方案之一。
Objective To observe the general effect of gemcitabine combined with cisplatin in the treatment of patients with anthracycline and taxane-resistant metastatic triple negative breast cancer (estrogen receptor, progesterone receptor, epidermal growth factor receptor 2 negative) Toxic reaction. Methods Twenty-six patients with metastatic triple-negative breast cancer who were treated from December 2011 to December 2013 were in first-line and second-line chemotherapy with anthracyclines and / or taxanes, with progression or initial treatment effective during the course of treatment But within 6 months of recurrence or progression. The admission of gemcitabine combined with cisplatin combined chemotherapy. Medication: gemcitabine 1 000 mg / m2d1, d8 intravenous infusion; cisplatin 80 mg / m2 intravenous infusion of 3 ~ 4 d. 21 d for a cycle, assessment of efficacy every 2 cycles. Results All of the 26 patients received at least 2 cycles of chemotherapy. Among them, 66.67% of patients with single site metastasis and 38.46% of patients with multiple sites of metastasis showed different degrees of toxicity Reaction, including myelosuppression, nausea, vomiting, hair loss, etc .; granulocyte colony stimulating factor, IL-11 can be gradually alleviated after application, no fatal infection or bleeding combined. Conclusion The gemcitabine combined with cisplatin has a higher rate of disease control. Adverse reactions to leukopenia, thrombocytopenia and nausea and vomiting are more common, but patients can tolerate it, so it can be used as anthracycline and taxane resistant One of the optional chemotherapy regimens for metastatic triple-negative breast cancer.