摘要
目的观察长春瑞滨联合顺铂（NP方案）在乳腺癌二线新辅助化疗中的价值。方法以2008年6月至2011年12月，在北京大学第一医院乳腺疾病中心住院接受蒽环类联合紫杉类化疗临床疗效评价为稳定，改行NP方案新辅助化疗的乳腺癌患者为研究对象，选择动态增强MRI并参照RECISTl．1标准进行临床评价，实施手术后参照Miller．Payne病理评价标准进行组织病理学疗效评价，并观察其不良反应。结果共33例患者入组，其中临床疗效评价完全缓解（cR）0例，部分缓解（PR）16例（48．5％），稳定（sD）17例（51．5％），进展（PD）0例，总有效率（CR＋PR）48．5％。组织病理学评价G16例（18．2％），G26例（18．2％），G310例（30．3％），G49例（27．2％），G52例（6．1％），有效率（G3＋G4＋G5）63．6％。不良反应主要为骨髓抑制，胃肠道反应及肝功能损害，无不能耐受化疗退出病例，元化疗相关死亡及重症感染。结论NP方案作为乳腺癌二线新辅助化疗方案疗效显著，患者耐受性良好，可作为二线新辅助化疗备选方案。
Objective To study the value of a combination of vinorelbine and cisplatin （NP） as second-line neoadjuvant chemotherapy regimen for primary breast cancer. Methods Primary breast cancer patients on neoadjuvant chemotherapy and non-responsive to anthracyelines plus taxans received the NP regimen. The clinical objective response was evaluated with dynamic contrast-enhanced magnetic resonance imaging （MRI） according to RECIST 1.1 before operation. The pathological response was evaluated by the Miller-Payne grading system. And the toxieities were observed and evaluated according to National Cancer Institute-Common Terminology Criteria Version 3.0 （ NCI-CTC v3.0）. Results A total of 33 breast cancer patients were examined. The outcomes were complete remission （CR, n = 0, 0% ）, partial remission （PR, n = 16, 48.5% ）, stable disease （ n = 17, 51.5% ） and progressive disease （ n = 0, 0% ）. The clinical responsive rate （CR ＋ PR） rate was 48.5%. The pathological response rates were G1 （n =6, 18. 2% ）, G2 （n=6, 18.2%）, G3 （n=10, 30.3%）, G4 （n=9, 27.2%） and G5 （n=2, 6.1%）. And the pathological response （ G3 ＋ G4 ＋ G5 ） was found in 21 cases （ 63.6% ）. The most common toxicities included neutropenia and nausea/vomiting. No serious toxicities were observed. Conclusion As a we/l- tolerated and effective regimen, NP regimen may be recommended as an option of second-line neoadjuvant chemotheraoy regimen for primary breast cancer.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2013年第2期93-95,共3页
National Medical Journal of China
基金
北京市科技计划项目（D090507043409010）
首都医学发展基金（2009·1011）
关键词
乳腺肿瘤
新辅助化疗
NP方案
Breast neoplasms
Neoadjuvant chemotherapy
NP regimen
