摘要
目的:高复发风险乳腺癌患者术后复发率高。目前,对于外周血干细胞移植支持下大剂量化疗在乳腺癌辅助治疗中的应用价值仍存有争议。本研究旨在探讨高复发风险乳腺癌患者术后接受外周血自体干细胞移植支持下大剂量化疗的疗效和安全性。方法:对24例高复发风险乳腺癌术后患者给予紫杉醇(175mg/m2)和粒细胞集落刺激因子(granulocyte colony-stimulating factor,G-CSF)(5μg/kg)以动员和采集外周血CD34+造血干细胞,然后进行2个周期的大剂量化疗,其中11例患者接受三药联合化疗方案[紫杉醇175mg/m2、塞替哌150mg/m2联合卡铂(设定血药浓度-时间曲线下面积=6,计算给药剂量为300mg/m2,分2d给药)],13例接受双药联合化疗方案(紫杉醇175mg/m2联合塞替哌150mg/m2)。化疗开始后第2天给予CD34+造血干细胞回输,第3天开始使用G-CSF,直至患者外周血白细胞计数连续3d均>10.0×109/L。观察大剂量化疗不良反应。计算中位无病生存(disease-free survival,DFS)期和3年DFS率。结果:中位随访期为32个月(3～62个月),中位DFS为32个月,3年DFS率为56.3%。大剂量化疗安全性良好,无治疗相关性死亡。结论:自体外周血造血干细胞移植支持下大剂量紫杉醇联合塞替哌化疗方案辅助治疗高复发风险乳腺癌术后患者的安全性良好,其DFS获益优于常规剂量辅助化疗。
Objective： Patients with high-risk breast cancer has a high recurrence rate. The clinical value of high-dose adjuvant chemotherapy supported by autologous HSCT （hematopoietic stem cell transplantation） for postoperative breast cancer patients with high risk of recurrence remains controversial. This study was to explore the efficacy and safety of high-dose adjuvant chemotherapy with paxlitaxel and thiotepa supported by autologous HSCT for postoperative breast cancer patients with high risk of recurrence, Methods： Twenty-four postoperative breast cancer patients （stages Ⅱ-Ⅲ） with high risk of recurrence were enrolled in this study. The patients received paclitaxel 175 mg/m^2 and G-CSF （granulocyte colony-stimulating factor） 5 μg/kg for mobilization and collection of peripheral blood CD34＋ stem cells. Then two cycles of high-dose adjuvant chemotherapy were given subsequently [1] patients： paclitaxel 175 mg/m^2 ＋ thiotepa 150 mg/m^2 ＋ carboplatin （area under curve = 6; 300 mg/m^2 divided in two days）; 13 patients： paclitaxel 175 mg/m^2 ＋thiotepa 150 mg/m^2） every 28 d]. The CD34＋ stem cells were infused for an autologous HSCT on day 2 after chemotherapy, and the G-CSF was started on day 3 after chemotherapy and discontinued until the peripheral WBC （white blood cell） count reached over 1 0.0×10^9/L continuously for three days. The adverse effects of highdose adjuvant chemotherapy were observed. The median DFS （disease-free survival） and the three-year DFS rate were calculated. Results： The median follow-up was 32 months （3-62 months）. The median DFS was 32 months.The three-year DFS rate was 56.3%. High-dose chemotherapy had a good safety profile and no treatment- related death. Conclusion： High-dose chemotherapy with paclitaxel and thiotepa supported by autologous HSCT in postoperative breast cancer patients with high risk of recurrence has a good safety profile and can obtain a better benefit of DFS as compared with standard-dose chemotherapy. These results s
出处
《肿瘤》
CAS
CSCD
北大核心
2013年第4期334-338,共5页
Tumor
关键词
乳腺肿瘤
高复发风险
辅助化疗
大剂量化疗
紫杉醇
塞替哌
外周血干细胞移植
Breast neoplasms
High risk of recurrence
Adjuvant chemotherapy
High-dose chemotherapy
Paclitaxel
Thiotepa
Peripheral blood stem cell transplantation
