摘要
目的评价多西他赛解救治疗紫杉醇耐药复发转移性乳腺癌的临床疗效。方法回顾性分析60例多西他赛治疗紫杉醇耐药的复发转移性乳腺癌患者的临床资料,对临床疗效及其影响因素等进行统计分析。结果全组患者中位年龄51岁。雌/孕激素受体阳性率65%,Her-2状态阳性率28.3%。多西他赛解救治疗紫杉醇耐药的复发转移性乳腺癌患者,客观缓解率为18.3%,临床获益率25.0%,中位PFS 4.0个月(3.38～4.62个月);耐药亚组分析结果显示原发耐药组与继发耐药组的客观缓解率及临床获益率无明显统计学差异(P=1.000;P=0.762),但多西他赛治疗紫杉醇耐药复发转移性乳腺癌继发耐药组的无进展生存期(PFS)要优于原发耐药组(2个月vs 6个月,P=0.008)。COX多因素分析显示多西他赛PFS与单位体表面积剂量、年龄、病理类型、Her-2状态、雌/孕激素受体表达状态、同侧腋窝淋巴结转移数目、复发转移部位数目等因素均无关,但与耐药情况、无病生存期、解救治疗线数、临床分期(P=0.001;P=0.029;P=0.037;P=0.034)等因素相关。结论紫杉醇耐药患者接受多西他赛解救治疗仍可获得一定的客观缓解率及临床获益率,二者部分交叉耐药。
Objective To evaluate the efficacy of docetaxel in patients with paclitaxel-resistant metastatic breast cancer. Methods 60 clinical records of metastatic breast cancer patients with paelitaxel-resistance were summarized ret- rospectively and the clinical effects and influencing factors of docetaxel were statistically analyzed. Results The median age was fifty-one years in the whole group. The positive rate of estrogen receptor or progesterone receptor was 65%, and the positive status of Her-2 was 28.3%. The objective response rates and the clinical benefit rates of doeetaxel in patients with paclitaxel-resistant metastatic breast cancer were 18.3% and 25.0%, and the median progression-free survival （PFS） was 4. 0 （3.38 -4. 62） months. There was no difference between the effects of primary paclitaxel-resistant group and seconda- ry paclitaxel-resistant group not only in objective response rates, but also in clinical benefit rates （ P = 1. 000 ; P = 0. 762）. However, the PFS of the latter was superior to the former （2 months vs 6 months, P = 0. 008）. Cox regression showed that the PFS of docetaxel had no association with the dose of body surface area per units, age, pathological type, status of estrogen/progesterone receptor, status of Her-2, lymph node metastatic status in patients with paclitaxel-rcsistant metastatic breast cancer, but was correlated with the resistance to paelitaxel, disease-free survival, treatmenl lines, clinical stages （P = 0. 001 ; P = 0. 029; P = 0. 037 ; P = 0. 034）. Conclusion Paclitaxet-resistant patients underwent do- eetaxel treatment still obtained certain objective response rates and clinieal benefit rates, and the paelitaxel and docetaxel were partially cross-resistant in patients.
出处
《癌症进展》
2012年第3期251-256,共6页
Oncology Progress
关键词
乳腺癌
紫杉醇耐药
多西他赛
客观缓解率
无进展生存期
breasl caneer paelitaxel-resistance docetaxel objective response rates progression-free survival
