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目的比较培美曲塞联合顺铂及吉西他滨联合顺铂两种方法治疗晚期乳腺癌的临床效果及不良反应。方法晚期乳腺癌患者68例随机分为培美曲塞组及吉西他滨组,每组34例。培美曲塞组患者采用培美曲塞联合顺铂治疗,吉西他滨组患者采用吉西他滨联合顺铂治疗,均治疗21 d。观察两组治疗效果及不良反应。结果治疗后培美曲塞组CR 4例,PR 15例,SD 10例,PD 5例,总有效率55.9%;吉西他滨组CR 5例,PR 15例,SD 10例,PD 4例,总有效率58.8%。两组总有效率相当(P>0.05)。两组患者主要不良反应均为恶心呕吐、贫血、白细胞及血小板减少。吉西他滨组白细胞减少18例(52.9%),培美曲塞组白细胞减少7例(20.6%),吉西他滨组白细胞减少发生率高于培美曲塞组(P<0.05)。其余不良反应发生率两组比较差异无统计学意义(P>0.05)。结论培美曲塞联合顺铂及吉西他滨联合顺铂两种方法治疗晚期乳腺癌均有较好疗效,但两者主要不良反应不同。
Objective To compare the clinical effects and adverse reactions of pemetrexed combined with cisplatin and gemcitabine combined with cisplatin in the treatment of advanced breast cancer. Methods 68 patients with advanced breast cancer were randomly divided into pemetrexed group and gemcitabine group, 34 cases in each group. Pemetrexed patients were treated with pemetrexed combined with cisplatin, gemcitabine patients treated with gemcitabine plus cisplatin, were treated for 21 days. The therapeutic effects and adverse reactions of the two groups were observed. Results In the pemetrexed group, there were 4 cases of CR, 15 cases of PR, 10 cases of SD and 5 cases of PD, and the total effective rate was 55.9%. In the gemcitabine group, there were 5 cases of CR, 15 cases of PR, 10 cases of SD and 4 cases of PD Efficiency 58.8%. The total effective rate was equal in both groups (P> 0.05). The main adverse reactions were nausea and vomiting, anemia, white blood cells and thrombocytopenia in both groups. In the gemcitabine group, leukopenia was found in 18 cases (52.9%), in the pemetrexed group, leukopenia was found in 7 cases (20.6%) and in the gemcitabine group was higher than in the pemetrexed group (P <0.05). The incidence of other adverse reactions was no significant difference between the two groups (P> 0.05). Conclusions Both pemetrexed combined with cisplatin and gemcitabine combined with cisplatin are effective in treating advanced breast cancer, but the main adverse reactions are different.