长春瑞滨联合顺铂治疗三阴性乳腺癌的临床观察

目的：观察长春瑞滨联合顺铂治疗三阴性乳腺癌临床疗效。方法：选择我院2007年5月～2011年8月期间收治经细胞学或病理学诊断并确诊TNBC患者85例,术后免疫学化疗证实ER、PR、HER-2均呈阴性,随机分组入试,长春瑞滨联合顺铂（NP组）45例,第1、8天予以静脉滴注长春瑞滨25 mg/m2,前3天辅以顺铂25 mg/m2滴注,21天为1个周期,治疗2个周期后观察临床疗效;紫杉醇联合顺铂（TP组）40例,第1天小剂量滴注紫杉醇135～175 mg/m2,,顺铂用量、用法及用药周期同上所示。对比观察病症缓释情况和毒副作用。结果：NP组总有效率（RR）48.89%,控制率（PD）为77.78%,TP组总有效率（RR）为37.50%,控制率（PD）55.56%,两组间有效率及控制率比较差异有统计学意义（P〈0.05）。两组常见毒副反应为骨髓抑制、消化道和胃肠道反应。NP组消化道反应和骨髓抑制微重于TP组,两组间比较有显著差异（P〈0.05）。结论：长春瑞滨联合顺铂（NP）新辅助化疗方案针对三阴性乳腺癌患者耐受性好、毒副反应较小、有效率高、不良反应可逆等优势,可作为临床推广药物。

Clinical Observation on Changchun Vinorelbine plus Cisplatin for Triple Negative Breast Cancer

Objective： To observe the clinical effect on Changchun vinorelbine plus cisplatin （CVPS） for triple negative breast cancer （TNBC）. Methods： A total of 85 patients were selected,who were admitted to Liaoning provincial tumor hospital between May 2007 and August 201 land diagnosed as TNBC by cytology or pathology. The immunological chemotherapy after operation confirmed that ER, PR, and HER-2 were negative. The 85 patients were randomly divided into CVPS/NP group（n=45）, at theist and 8th day, giving vinorelbine 25 mg/m2 by intravenous drip （Supplemented by cisplatin 25 mg/m2 infusion at first three days）, 21 days of a cycle, clinical efficacy was observed after two cycles of treatment; Paclitaxel and cisplatin/TP group（n=40 ）, at day 1, a small dose infusion ofpaclitaxel 135 - 175mg/m2, dosage, usage, and medication cycle of cisplatin were the same as CVPS group. The illnesses sustained-release and side effects of the two groups were observed and compared. Results： The total response rate （RR） in CVPS group was 48.89%, control rate was 77.78%; The total response rate （RR） in paclitaxel and cisplatin group was 37.50%, control rate, 55.56%, with statistical significance between the two groups （P 〈 0.05）. Common toxicities in the two groups were myelosuppression and gastrointestinal tract reactions, CVPS group was slightly heavier than Paclitaxel and cisplatin group, with significant differences （P〈0.05）. Conclusion： Changehun vinorelbine plus cisplatin（CVPS） for patients with triple negative breast cancer has many advantages,such as good tolerance, less toxicity, high effective rate, reversible side effects,etc., which can be widely used as clinical drugs.