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目的观察紫杉醇联合阿霉素/吡柔比星化疗方案治疗晚期乳腺癌的疗效、安全性及毒副反应。方法经病理证实的晚期乳腺癌患者45例,其中乳腺癌肺转移28例,肝转移8例,骨转移25例。既往未曾采用过蒽环类药物者17例给紫杉醇联合阿霉素方案化疗,既往曾采用过蒽环类药物者28例给予紫杉醇联合吡柔比星方案化疗,21 d为一个周期,2周期后评价疗效。有效者给予4周期的化疗。结果45例患者均可评价疗效,其中联合阿霉素组CR 1例,PR 8例,SD 5例,PD 3例,总有效率(CR+PR)为52.9%;联合吡柔比星组CR 2例,PR 13例,SD 9例,PD 4例,总有效率为53.6%。主要毒副反应为脱发、骨髓抑制、消化道反应和心脏毒性。其中联合阿霉素组Ⅲ度以上白细胞减少发生率为47.1%,联合吡柔比星组为35.7%;S-T段的改变及心律失常的发生率:联合阿霉素组为29.4%,联合吡柔比星组为10.7%。结论紫杉醇联合阿霉素/吡柔比星方案治疗晚期乳腺癌有较好的疗效,毒副反应可以耐受,而且吡柔比星组较阿霉素组的心脏毒性及骨髓抑制更小,因此,吡柔比星对于老年患者及曾接受过蒽环类药物治疗的患者更安全且有效。
Objective To observe the efficacy, safety and toxicity of paclitaxel combined with doxorubicin / pirarubicin in the treatment of advanced breast cancer. Methods 45 cases of advanced breast cancer confirmed by pathology, including 28 cases of lung metastasis of breast cancer, 8 cases of liver metastasis and 25 cases of bone metastasis. Paclitaxel combined with doxorubicin chemotherapy was given to 17 patients who had not used anthracyclines before, 28 patients who had used anthracyclines before and received paclitaxel plus pirarubicin regimen, 21 days for one cycle and 2 cycles later Evaluation of efficacy. Effective to give 4 cycles of chemotherapy. Results All the 45 patients could evaluate the curative effect. The combination of adriamycin group CR 1, PR 8, SD 5 and PD 3 cases, the total effective rate (CR + PR) was 52.9%; combined with pirarubicin CR 2 cases, PR 13 cases, SD 9 cases, PD 4 cases, the total effective rate was 53.6%. The main side effects are alopecia, myelosuppression, gastrointestinal reactions and cardiotoxicity. The incidence of grade Ⅲ leukopenia in the combined doxorubicin group was 47.1%, in combination with pirarubicin group was 35.7%; ST segment changes and the incidence of arrhythmia were 29.4% in combination with doxorubicin Than the star group was 10.7%. Conclusion Paclitaxel combined with doxorubicin / pirarubicin has a good curative effect on advanced breast cancer. Toxicity and side effects can be tolerated, and the cardiotoxicity and myelosuppression in the pirarubicin group is less than that in the doxorubicin group. Therefore, , Pirarubicin is safer and more effective for elderly patients and those who have previously received anthracycline therapy.