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目的:观察长春瑞滨联合顺铂治疗三阴性乳腺癌临床疗效。方法:选择我院2007年5月～2011年8月期间收治经细胞学或病理学诊断并确诊TNBC患者85例,术后免疫学化疗证实ER、PR、HER-2均呈阴性,随机分组入试,长春瑞滨联合顺铂(NP组)45例,第1、8天予以静脉滴注长春瑞滨25 mg/m2,前3天辅以顺铂25 mg/m2滴注,21天为1个周期,治疗2个周期后观察临床疗效;紫杉醇联合顺铂(TP组)40例,第1天小剂量滴注紫杉醇135～175 mg/m2,,顺铂用量、用法及用药周期同上所示。对比观察病症缓释情况和毒副作用。结果:NP组总有效率(RR)48.89%,控制率(PD)为77.78%,TP组总有效率(RR)为37.50%,控制率(PD)55.56%,两组间有效率及控制率比较差异有统计学意义(P<0.05)。两组常见毒副反应为骨髓抑制、消化道和胃肠道反应。NP组消化道反应和骨髓抑制微重于TP组,两组间比较有显著差异(P<0.05)。结论:长春瑞滨联合顺铂(NP)新辅助化疗方案针对三阴性乳腺癌患者耐受性好、毒副反应较小、有效率高、不良反应可逆等优势,可作为临床推广药物。
Objective: To observe the clinical efficacy of vinorelbine plus cisplatin in the treatment of triple negative breast cancer. Methods: From May 2007 to August 2011 in our hospital, 85 patients with TNBC diagnosed by cytology or pathology and confirmed by immunocytochemistry confirmed that ER, PR and HER-2 were negative and were randomly divided into Trial, vinorelbine plus cisplatin (NP group) 45 cases, the first 1,8 days of intravenous infusion of vinorelbine 25 mg / m2, the first 3 days with cisplatin 25 mg / m2 infusion, 21 days for the 1 The clinical efficacy was observed after 2 cycles of treatment. Paclitaxel combined with cisplatin (TP group) 40 cases, the first day of low-dose instillation of paclitaxel 135 ~ 175 mg / m2, cisplatin dosage, usage and medication cycle as shown above . Comparative observation of slow release and toxic side effects. Results: The total effective rate (RR) 48.89%, the control rate (PD) in NP group was 77.78%, the total effective rate (RR) and the control rate (PD) were 37.50% and 55.56% The difference was statistically significant (P <0.05). Common side effects of two groups of bone marrow suppression, gastrointestinal and gastrointestinal reactions. The digestive tract reaction and myelosuppression in the NP group were more severe than those in the TP group, with significant difference between the two groups (P <0.05). Conclusions: The combination of vinorelbine and cisplatin (NP) neoadjuvant chemotherapy regimen has the advantages of good tolerability, low toxic and side effects, high efficiency and reversible side effects in patients with triple negative breast cancer.