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目的:观察洛铂联合长春瑞滨(NL方案)或顺铂联合长春瑞滨(NP方案)对蒽环及紫杉类药物治疗失败的晚期转移性乳腺癌的疗效及不良反应。方法:对39例确诊为蒽环类、紫杉类治疗失败的晚期转移性乳腺癌患者随机分为NL方案组或NP方案组治疗。NL方案组20例,长春瑞滨(NVB)25mg/m2,静脉滴入,d1,d8;洛铂(LBP)30mg/m2,静脉滴入,d1。NP方案组19例,NVB 25mg/m2,静脉滴入,d1、d8;顺铂(DDP)30mg/m2,静脉滴入,d1～d3。21d为1个周期,至少2个周期。结果:39例患者均可评价疗效,NL组总有效率(RR)为60%(12/20),NP组为47.4%(9/19),两组比较差异无统计学意义,P>0.05;中位疾病进展时间(TTP)NL组为94d,NP组为128d,两组比较差异无统计学意义,P>0.05。主要不良反应为骨髓抑制和胃肠道反应,NP组患者恶心、呕吐发生率明显高于NL组,P<0.05;但白细胞减少及血小板减少发生率差异无统计学意义,P>0.05。结论:对蒽环、紫杉类耐药的晚期乳腺癌,NL方案是一个安全、有效的化疗方案。
OBJECTIVE: To observe the curative effect and side effects of lobaplatin plus vinorelbine (NL regimen) or cisplatin plus vinorelbine (NP regimen) on patients with advanced metastatic breast cancer who failed anthracycline and taxane treatment. Methods: Thirty-nine patients with advanced metastatic breast cancer who were diagnosed as anthracycline or taxane failure were randomly divided into treatment group (NL group) and NP group. NL regimen group 20 cases, vinorelbine (NVB) 25mg / m2, intravenous infusion, d1, d8; lobaplatin (LBP) 30mg / m2, intravenous infusion, d1. Nineteen patients in the NP regimen, NVB 25mg / m2, intravenous infusion, d1, d8; DDP 30mg / m2, intravenous infusion, d1 ~ d3.21d for a period of at least 2 cycles. Results: All 39 patients were evaluated. The total effective rate (RR) was 60% (12/20) in NL group and 47.4% (9/19) in NP group. There was no significant difference between the two groups (P> 0.05) ; The median time to progression (TTP) was 94 days in NL group and 128 days in NP group, there was no significant difference between the two groups (P> 0.05). The main adverse reactions were myelosuppression and gastrointestinal reactions. The incidence of nausea and vomiting in NP patients was significantly higher than that in NL patients (P <0.05). However, the incidence of leukopenia and thrombocytopenia was not significantly different (P> 0.05). Conclusion: NL regimen is a safe and effective chemotherapy regimen for anthracycline and taxane-resistant advanced breast cancer.