摘要
目的探讨吉西他滨不同给药间隔时间对晚期乳腺癌的疗效及远期预后的影响。方法选取2015年8月~2016年8月收治的晚期乳腺癌患者80例,采用随机数字表分成A组和B组。其中A组40例,脱落病例1例,共完成39例;B组40例,脱落病例2例,共完成38例(脱落病例指:筛选合格进入临床试验研究但未完成临床试验全过程的病例)。A组患者接受吉西他滨1000 mg/m^(2),d1、d8;顺铂25 mg/m^(2),d1~3方案化疗。B组患者接受吉西他滨1000 mg/m^(2),d1、d5;顺铂25 mg/m^(2),d1~3方案化疗。化疗4个周期后,评定两组患者的治疗效果,记录并统计患者住院时间和费用,随访疾病进展情况,并对比两组患者的生存情况。结果化疗前,A、B两组患者血清中糖类抗原125(CA125)、糖类抗原153(CA153)、癌胚抗原(CEA)水平的差异无统计学意义(P>0.05)。接受4个周期化疗后,A、B两组患者的疗效分级、RR、DCR水平差异无统计学意义(P>0.05),但血清中CA125、CA153、CEA水平相对于化疗前均显著降低(P<0.01),并且B组显著低于A组(P<0.01)。化疗期间,B组患者白细胞减少、中性粒细胞减少、肝功能异常、心脏毒性等毒副反应发生率均显著低于A组(P<0.05),消化道不良反应发生率的组间差异无统计学意义(P>0.05)。单个化疗周期内,B组患者的平均住院时间、平均住院费用均少于A组患者(P<0.001)。两组患者的远期生存时间差异无统计学意义(P>0.05)。结论不同用药间隔时间的吉西他滨化疗方案对患者的近期疗效存在一定差异性,缩短用药间隔时间对血清CA125、CA153、CEA水平具有一定的影响,但不会增加毒副反应发生,并且在缩短患者住院时间、降低医疗支出方面具有积极作用,对患者远期的预后结果相似。
Objective To investigate the effect of gemcitabine with different administration intervals in the treatment of advanced breast cancer and its influence on long-term prognosis.Methods 80 cases with advanced breast cancer admitted to hospital from August 2015 to August 2016 were selected and randomly divided into group A and group B.Among 40 cases in the group A,there were 1 shedding case and 39 completed cases.Among 40 cases in the group B,there were 2 shedding cases and 38 completed cases(shedding case referred to the case that qualified to enter the clinical trial but did not complete the whole process of the clinical trial).Patients in the group A were given the following chemotherapy regimen:gemcitabine 1000 mg/m^(2),d1 and d8;cisplatin 25 mg/m^(2),d1 to d3.And those in the group B were treated with gemcitabine 1000 mg/m^(2),d1 and d5;cisplatin 25 mg/m^(2),d1 to d3.After 4 cycles of chemotherapy,the therapeutic effects of the two groups were evaluated,the hospitalization time and expenses were recorded and counted,the disease progress was followed up,and the survival situation of the two groups was compared.Results Before chemotherapy,there was no statistically significant difference in serum carbohydrate antigen 125(CA125),carbohydrate antigen 153(CA153)and carcinoembryonic antigen(CEA)levels between the group A and the group B(P>0.05).After 4 cycles of chemotherapy,there was no statistically significant difference in the efficacy grading,RR and DCR levels between the group A and the group B(P>0.05),but the serum CA125,CA153 and CEA levels were significantly lower than those before chemotherapy(P<0.01),and those in the group B were significantly lower than those in the group A(P<0.01).During chemotherapy,the incidence of leukopenia,neutropenia,abnormal liver function and cardiotoxicity in the group B was significantly lower than that in the group A(P<0.05),and there was no statistically significant difference in the incidence of gastrointestinal adverse reactions between groups(P>0.05).In a single chemotherap
作者
闫文明
张继锋
YAN Wenming;ZHANG Jifeng(Department of Oncology,Luyi people's Hospital,Luyi 477200,Henan,China)
出处
《右江医学》
2021年第7期515-520,共6页
Chinese Youjiang Medical Journal
关键词
晚期乳腺癌
吉西他滨
肿瘤标志物
毒副反应
远期预后
advanced breast cancer
gemcitabine
tumor marker
toxic and side effect
long-term prognosis
