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目的:观察吉西他滨联合希罗达治疗蒽环类和紫杉类药物治疗失败乳腺癌肝转移的疗效。方法:收治42例女性乳腺癌化疗后合并肝转移患者,采取吉西他滨1000mg/m2,静脉滴注,第1,8天;希罗达2000mg/m2,口服,第1~14天。3周为1个周期。连续做2个周期化疗后评价疗效。结果:42例患者CR1例(2.4%),PR13例(31%),SD12例(28.6%),PD16例(38.1%),有效率(CR+PR)为33.3%(14/42),临床获益率(CR+PR+SD)为61.9%(26/42)。不良反应:白细胞减少Ⅰ~Ⅱ度占69%(29/42),Ⅲ~Ⅳ度占23.8%(10/42),血小板减少Ⅰ~Ⅱ度占47.6%(20/42),Ⅲ~Ⅳ度占7.1%(3/42)。消化道反应Ⅰ~Ⅱ度发生率45.2%(19/42),Ⅲ~Ⅳ度恶心呕吐发生率为0。Ⅲ~Ⅳ度腹泻发生率2.4%(1/42)。手足综合征Ⅰ~Ⅱ度发生率31%(13/42)。结论:对蒽环类和紫杉类药物治疗失败乳腺癌肝转移患者,在可供选择的方案非常少的情况下,吉西他滨联合希罗达化疗方案是一种不错的选择。
Objective: To observe the efficacy of gemcitabine combined with Xeloda in the treatment of liver metastases of failed breast cancer patients treated with anthracyclines and taxanes. Methods: Forty-two patients with breast cancer who underwent chemotherapy and liver metastasis were treated with gemcitabine 1000 mg / m 2 intravenously on Days 1 and 8 and Xeloda 2000 mg / m 2 orally on Days 1 to 14. 3 weeks for 1 cycle. After 2 cycles of continuous chemotherapy to evaluate the efficacy. Results: Of the 42 patients, CR1 (2.4%), PR 13 (31%), SD12 (28.6%), PD16 (38.1%) and CR + PR were 33.3% The rate of return (CR + PR + SD) was 61.9% (26/42). Adverse reactions: 69% (29/42) were grade Ⅰ ~ Ⅱ, 23.8% (Ⅲ / Ⅳ) were grade Ⅲ ~ Ⅳ, 47.6% (20/42) were grade Ⅰ ~ Ⅱ thrombocytopenia, Ⅲ ~ Ⅳ Accounting for 7.1% (3/42). The incidence of Ⅰ ~ Ⅱ degree of digestive tract reaction was 45.2% (19/42), and the incidence of nausea and vomiting Ⅲ ~ Ⅳ was 0. Ⅲ ~ Ⅳ diarrhea incidence of 2.4% (1/42). Hand-foot syndrome Ⅰ ~ Ⅱ incidence of 31% (13/42). CONCLUSIONS: Gemcitabine combined with Xeloda chemotherapy is a good alternative to patients with liver metastases of breast cancer who have failed treatment for anthracyclines and taxanes, with very few options available.