卡培他滨节拍化疗联合依西美坦对绝经后PR阳性乳腺癌患者的效果分析
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摘要
目的探讨卡培他滨节拍化疗联合依西美坦对绝经后孕激素受体(PR)阳性乳腺癌患者生存期的影响。方法选择2014年7月-2017年7月我院收治的92例绝经后PR阳性乳腺癌患者为研究对象,采用随机数字表法分为观察组和对照组,各46例。观察组患者给予卡培他滨节拍化疗+依西美坦治疗,对照组患者给予卡培他滨常规化疗+依西美坦治疗。比较两组患者疗效、不良反应、生活质量以及生存时间。结果两组患者治疗有效率(RR)和疾病控制率(DCR)比较,差异均无统计学意义(P>0.05);观察组患者骨髓抑制、消化道反应、手足综合征等不良反应发生率均显著低于对照组(P<0.05),生活质量改善情况显著优于对照组(P<0.05);两组患者中位肿瘤无进展生存时间(PFS)比较,差异无统计学意义(P>0.05)。结论与常规剂量治疗方案比较,卡培他滨节拍化疗联合依西美坦治疗绝经后PR阳性乳腺癌的疗效和生存期相当,但节拍化疗可减少不良反应,更有利于提高患者的生活质量。
Objective To explore the effects of capecitabine metronomic chemotherapy combined with exemestane on the survival time of patients with postmenopausal progesterone receptor(PR)-positive breast cancer. Methods A total of 92 patients with postmenopausal PR-positive breast cancer in our hospital were selected for the study and were divided into observation group and control group according to the random number table method, with 46 cases in each group. Observation group was given capecitabine metronomic chemotherapy plus exemestane, and control group was given conventional capecitabine chemotherapy plus exemestane. The efficacy, adverse reactions, quality of life improvement and the survival time were compared between the two groups. Results There were no significant differences in RR and DCR between the two groups(P>0.05). The incidence rates of adverse reactions like bone marrow suppression, digestive tract reaction and hand-foot syndrome in observation group were lower than in control group(P<0.05), and the quality of life improvement was better in observation group than in control group(P<0.05). There was no significant difference in the median tumor progression-free survival time(PFS)between the two groups(P>0.05). Conclusions Capecitabine metronomic chemotherapy combined with exemestane for postmenopausal PR-positive breast cancer achieved equal efficacy and survival time to conventional treatment regimen. However, metronomic chemotherapy can reduce the adverse reactions and help to improve the quality of life.
Objective To explore the effects of capecitabine metronomic chemotherapy combined with exemestane on the survival time of patients with postmenopausal progesterone receptor(PR)-positive breast cancer. Methods A total of 92 patients with postmenopausal PR-positive breast cancer in our hospital were selected for the study and were divided into observation group and control group according to the random number table method, with 46 cases in each group. Observation group was given capecitabine metronomic chemotherapy plus exemestane, and control group was given conventional capecitabine chemotherapy plus exemestane. The efficacy, adverse reactions, quality of life improvement and the survival time were compared between the two groups. Results There were no significant differences in RR and DCR between the two groups(P>0.05). The incidence rates of adverse reactions like bone marrow suppression, digestive tract reaction and hand-foot syndrome in observation group were lower than in control group(P<0.05), and the quality of life improvement was better in observation group than in control group(P<0.05). There was no significant difference in the median tumor progression-free survival time(PFS)between the two groups(P>0.05). Conclusions Capecitabine metronomic chemotherapy combined with exemestane for postmenopausal PR-positive breast cancer achieved equal efficacy and survival time to conventional treatment regimen. However, metronomic chemotherapy can reduce the adverse reactions and help to improve the quality of life.
引文
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[9]徐滨,徐明静,马欢,等.多西他赛联合卡培他滨姑息治疗对晚期乳腺癌患者生存期的影响及其疗效[J].肿瘤药学,2018, 8(3):448-450. doi:10.3969/j. issn.2095-1264.2018.03.35.
[10]Tsai CC, Qiu JT, Tseng CW, et al. Low-dose metronomic chemotherapy with cisplatin enhanced immunity in a murine model of ectopic cervical cancer[J].Clin Exp Pharmacol Physiol, 2016, 43(2):251-258. doi:10.1111/1440-1681.12515.
[11]Otsuka M, Yamasaki O, Kaji T, et al. Metastatic Cutaneous Apocrine Adenocarcinoma Treated With a Combination of Pertuzumab-Based Targeted Therapy and Taxane Chemotherapy:A Case Report[J]. JAMA Dermatol, 2016, 152(1):111-113. doi:10.1001/jamadermatol.2015.2507.
[12]Tagliamonte M, Petrizzo A, Napolitano M, et al. A novel multi-drug metronomic chemotherapy significantly delays tumor growth in mice[J]. J Transl Med, 2016, 14:58. doi:10.1186/s12967-016-0812-1.
[13]Natori A, Ethier JL, Amir E, et al. Capecitabine in early breast cancer:A meta-analysis of randomised controlled trials[J]. Eur J Cancer, 2017, 77:40-47. doi:10.1016/j. ejca.2017.02.024.
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[15]Walter KR, Ford ME, Gregoski MJ, et al. Advanced glycation end products are elevated in estrogen receptor-positive breast cancer patients, alter response to therapy, and can be targeted by lifestyle intervention[J]. Breast Cancer Res Treat, 2018. doi:10.1007/s10549-018-4992-7.
[2]Tate SC, Andre V, Enas N, et al. Early change in tumour size predicts overall survival in patients with first-line metastatic breast cancer[J]. Eur J Cancer, 2016, 66:95-103.doi:10.1016/j. ejca.2016.07.009.
[3]Tanaka S, Iwamoto M, Kimura K, et al. A Phase II Study of Adjuvant Chemotherapy of Tegafur-Uracil for Patients with Breast Cancer with HER2-negative Pathologic Residual Invasive Disease after Neoadjuvant Chemotherapy[J]. Anticancer Res,2016, 36(12):6505-6509. doi:10.21873/anticanres.11250.
[4]Krajewski KM1, Nishino M, Ramaiya NH, et al. RECIST 1.1compared with RECIST 1.0 in patients with advanced renal cell carcinoma receiving vascular endothelial growth factortargeted therapy[J]. AJR Am J Roentgenol, 2015, 204(3):W282-W288. doi:10.2214/AJR.14.13236.
[5]Lu HP, Ma FF, Gong JR, et al. Effects of Oridonin combined with Capecitabine on the proliferaction of MDA-MB-231 human breast cancer cells[J]. Zhonghua Yi Xue Za Zhi, 2017, 97(46):3647-3651. doi:10.3760/cma. j. issn.0376-2491.2017.46.011.
[6]de Kock I, Mirhosseini M, Lau F, et al. Conversion of Karnofsky Performance Status(KPS)and Eastern Cooperative Oncology Group Performance Status(ECOG)to Palliative Performance Scale(PPS), and the interchangeability of PPS and KPS in prognostic tools[J]. J Palliat Care, 2013, 29(3):163-169. doi:10.1177/082585971302900305
[7]Wapnir IL, Price KN, Anderson SJ, et al. Efficacy of Chemotherapy for ER-Negative and ER-Positive Isolated Locoregional Recurrence of Breast Cancer:Final Analysis of the CALOR Trial[J]. J Clin Oncol, 2018, 36(11):1073-1079. doi:10.1200/JCO.2017.76.5719.
[8]Kurozumi S, Matsumoto H, Inoue K, et al. Impact of combining the progesterone receptor and preoperative endocrine prognostic index(PEPI)as a prognostic factor after neoadjuvant endocrine therapy using aromatase inhibitors in postmenopausal ER positive and HER2 negative breast cancer[J]. PLoS One, 2018,13(8):e0201846. doi:10.1371/journal. pone.0201846.
[9]徐滨,徐明静,马欢,等.多西他赛联合卡培他滨姑息治疗对晚期乳腺癌患者生存期的影响及其疗效[J].肿瘤药学,2018, 8(3):448-450. doi:10.3969/j. issn.2095-1264.2018.03.35.
[10]Tsai CC, Qiu JT, Tseng CW, et al. Low-dose metronomic chemotherapy with cisplatin enhanced immunity in a murine model of ectopic cervical cancer[J].Clin Exp Pharmacol Physiol, 2016, 43(2):251-258. doi:10.1111/1440-1681.12515.
[11]Otsuka M, Yamasaki O, Kaji T, et al. Metastatic Cutaneous Apocrine Adenocarcinoma Treated With a Combination of Pertuzumab-Based Targeted Therapy and Taxane Chemotherapy:A Case Report[J]. JAMA Dermatol, 2016, 152(1):111-113. doi:10.1001/jamadermatol.2015.2507.
[12]Tagliamonte M, Petrizzo A, Napolitano M, et al. A novel multi-drug metronomic chemotherapy significantly delays tumor growth in mice[J]. J Transl Med, 2016, 14:58. doi:10.1186/s12967-016-0812-1.
[13]Natori A, Ethier JL, Amir E, et al. Capecitabine in early breast cancer:A meta-analysis of randomised controlled trials[J]. Eur J Cancer, 2017, 77:40-47. doi:10.1016/j. ejca.2017.02.024.
[14]Ledzewicz U, Wang S, Schattler H, et al. On drug resistance and metronomic chemotherapy:A mathematical modeling and optimal control approach[J]. Math Biosci Eng, 2017,14(1):217-235. doi:10.3934/mbe.2017014.
[15]Walter KR, Ford ME, Gregoski MJ, et al. Advanced glycation end products are elevated in estrogen receptor-positive breast cancer patients, alter response to therapy, and can be targeted by lifestyle intervention[J]. Breast Cancer Res Treat, 2018. doi:10.1007/s10549-018-4992-7.