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目的 :评价长春瑞滨联合表阿霉素治疗乳腺癌的疗效和毒副反应。方法 :多中心前瞻性临床研究。乳腺癌患者 5 9例 ,应用长春瑞滨 2 5mg/m2 d1、d5静滴 ,表阿霉素 70mg/m2 d1静注 ,每 2 8d为 1周期 ,每个患者 2周期。静注恩丹西酮±地塞米松预防呕吐。结果 :全组总缓解率 (OR) 6 9 5 % ,其中完全缓解率 (CR) 8 5 %。初次化疗患者OR 76 7% ,CR 13 3% ;再次化疗患者OR 6 2 1% ,CR 3 5 %。乳腺原发灶OR 77 4% ,CR 16 1% ;转移灶OR6 1 3% ,CR 6 5 % ,其中腋窝淋巴结转移灶OR 6 8 0 % ,CR 8 0 % ;肝、肺转移灶各部分缓解 (PR) 5 0 0 %。毒副反应以白细胞低下和呕吐最为常见 ,其发生率分别为 95 8%和 87 3 %。其中Ⅲ°和Ⅳ°白细胞低下发生率分别高达37 3%和 17 0 % ,Ⅲ°和Ⅳ°中性粒细胞低下的发生率分为 18 6 %和 19 5 % ,32例患者需治疗性应用粒细胞集落刺激因子。Ⅲ°血小板低下和贫血的发生率分别为 5 9%和 2 5 %。Ⅲ°脱发的发生率为 14 4% ,Ⅳ°便秘的发生率为0 8%。结论 :长春瑞滨联合表阿霉素化疗对初治与复发乳腺癌均有较高疗效 ,但其重度骨髓抑制发生率较高 ,须引起足够重视
Objective : To evaluate the efficacy and toxicity of vinorelbine and epirubicin in the treatment of breast cancer. Methods: A multicenter prospective clinical study. In 59 patients with breast cancer, vinorelbine 25mg/m2 d1, d5 intravenous infusion, epirubicin 70mg/m2 d1 intravenous injection, every 2 8d for 1 cycle, 2 cycles per patient. Intravenous Ondansetron ± dexamethasone to prevent vomiting. Results: The total remission rate (OR) was 695% in the whole group, and the complete remission rate (CR) was 85%. Patients with primary chemotherapy had OR 76 7% and CR 13 3%. Patients with re-chemotherapy had OR 62 1% and CR 3 5%. The primary breast lesions were OR 77 4%, CR 16 1%, OR 6 3%, CR 6 5%, and the axillary lymph node metastases were OR 68.0%, CR 80%. The liver and lung metastases were partially relieved. (PR) 500%. The most common side effects were leukopenia and vomiting, with a frequency of 95 8% and 87 3%, respectively. Among them, the incidence of leukopenia at III° and IV° was as high as 37 3% and 170%, respectively. The incidence of neutropenia at III° and IV° was divided into 18 6 % and 19 5 %. 32 patients required therapeutic application. Granulocyte colony stimulating factor. The incidence of III血小板 platelet hypoxia and anemia were 59% and 25%, respectively. The incidence of III° hair loss was 14%, and the incidence of IV° constipation was 08%. Conclusion : Vinorelbine combined with epirubicin chemotherapy has higher curative effect on newly diagnosed and recurrent breast cancers, but its incidence of severe myelosuppression is high and must be given enough attention.