【摘要】：目的分析卡培他濱單藥治療耐藥后的轉(zhuǎn)移性乳腺癌患者接受替吉奧單藥治療的療效及安全性。方法回顧性分析2011年11月—2015年5月寧波大學醫(yī)學院附屬醫(yī)院腫瘤內(nèi)科治療的22例轉(zhuǎn)移性乳腺癌患者的臨床資料。22例患者接受卡培他濱單藥治療,在卡培他濱耐藥后接受替吉奧單藥治療,直至疾病進展、不可耐受的毒副作用或患者拒絕治療。按照實體瘤療效評價標準(RECIST)進行替吉奧臨床療效評價,觀察進展時間(TTP)及總生存期(OS),記錄疼痛評分及CA153水平,根據(jù)美國國家癌癥研究所發(fā)布的常見不良反應事件評價標準(CTCAE v4.02)進行毒副作用評價。結果 22例卡培他濱耐藥的轉(zhuǎn)移性乳腺癌患者接受替吉奧治療后5例部分緩解,12例疾病穩(wěn)定,5例疾病進展,客觀有效率(ORR)為22.7%(5/22),臨床獲益率(CBR)為77.3%(17/22);中位TTP為113 d(22~218 d),中位OS為20.2個月(3.8~38.2個月)。替吉奧治療前有15例患者有疼痛表現(xiàn),未經(jīng)提高止痛藥物劑量,治療后10例患者疼痛減輕。開始替吉奧治療時CA153水平與治療過程中最低CA153水平比較,差異有統(tǒng)計學意義[(174.8±67.4)U/ml與(102.8±69.7)U/ml,t=4.174,P=0.001]。替吉奧治療的毒副作用均可耐受,主要毒副作用有厭食[59.1%(13/22)]、惡心[50.0%(11/22)]、乏力[45.5%(10/22)]、中性粒細胞計數(shù)減少[45.5%(10/22)]、貧血[40.9%(9/22)]、腹瀉[36.4%(8/22)]、手足綜合征[27.3%(6/22)]、轉(zhuǎn)氨酶升高[22.7%(5/22)]及嘔吐[18.2%(4/22)]等。毒副作用多為Ⅰ~Ⅱ級,僅3例發(fā)生Ⅲ級毒副作用。結論替吉奧單藥對于卡培他濱單藥耐藥的轉(zhuǎn)移性乳腺癌有一定的療效,而且耐受性良好。因此,對于使用卡培他濱單藥治療后耐藥的轉(zhuǎn)移性乳腺癌可考慮選用替吉奧單藥治療。
[Abstract]:Objective to evaluate the efficacy and safety of capecitabine in the treatment of metastatic breast cancer after drug resistance. Methods the clinical data of 22 patients with metastatic breast cancer treated by Department of Oncology, affiliated Hospital of Ningbo University Medical College from November 2011 to May 2015 were analyzed retrospectively. 22 patients were treated with capecitabine alone. After capecitabine resistance, teguir alone is given until the disease progresses, intolerable side effects or patients refuse treatment. According to the criteria for evaluating the curative effect of solid tumor, (RECIST) was used to evaluate the clinical efficacy of teguir. The progressive time (TTP), total survival time (OS),) and total survival time (OS),) were observed to record pain score and CA153 level. The toxicity and side effects were evaluated according to CTCAE v4.02, published by the National Cancer Institute. Results 22 patients with metastatic breast cancer who were resistant to capecitabine were treated with teguir in 5 patients with partial remission 12 patients with stable disease and 5 patients with disease progression. The objective effective rate (ORR) was 22.7% (5 / 22), the clinical benefit rate (CBR) was 77.3% (17 / 22) and the median TTP was 113d (median OS = 20.2 months (3.8 ~ 38.2 months) for 22218 d),). There were 15 patients with pain symptoms before tigor treatment and 10 patients with pain relief after treatment without increasing the dose of analgesic drugs. There was a significant difference between the level of CA153 and the lowest level of CA153 (174.8 鹵67.4) U/ml and (102.8 鹵69.7) U / ml ~ (-1) U/ml at the beginning of tiguir treatment [(174.8 鹵67.4) U/ml and (102.8 鹵69.7) U / ml ~ (4.174) U/ml]. The main side effects of tigor were anorexia [59.1% (13 / 22)], nausea [50.0% (11 / 22)], fatigue [45.5% (10 / 22)], neutrophil count decrease [45.5% (10 / 22)], anemia [40.9% (9 / 22)], diarrhea [36.4% (8 / 22)], hand and foot syndrome (27.3% (6 / 22)], elevated transaminase [22.7% (5r22)] and vomiting (418.22%). Most of the toxic side effects were grade 鈪，

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