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吉西他滨联合顺铂治疗预处理转移性乳腺癌患者的安全性和有效性。

Safety and efficacy of gemcitabine plus cisplatin combination in pretreated metastatic breast cancer patients.

机构信息

Department of Gynecology and Obstetrics, School of Medicine of Ribeirão Preto, São Paulo University, Avenida Bandeirantes 3900, 8th Floor, Ribeirão Preto, SP 14048-900, Brazil.

出版信息

Med Oncol. 2012 Mar;29(1):33-8. doi: 10.1007/s12032-010-9793-8. Epub 2011 Jan 25.

Abstract

Metastatic breast cancers (MBC) previously treated with anthracyclines (A) and taxanes (T) have a complicated management. Gemcitabine (G)-cisplatin (C) combinations have been used as synergistic salvage therapy in MBC and are considered as another option for patients with important symptoms and aggressive visceral disease. We analyzed the safety and efficacy of GC in AT-pretreated MBC, as well as overall survival (OS) and time to progression (TTP). Forty-nine subjects received IV G 750 mg/m(2) and C 30 mg/m(2), both d1 and d8 every 3 weeks. Response evaluation was performed every second cycle and in the end of treatment. GC protocol was the first-line palliative chemotherapy in half of the cases, and median number of cycles/patient were 4(2-12). Lung (75.5%) was the most frequent site of metastasis. Most of the patients related clinical improvement with chemotherapy with minimal/mild tolerable collateral effects in 85.7% of cases. Following 34 months, mean OS/TTP was 13.12/6.6 months. Objective-responded patients (40.3%) were statistically associated with the improvement in symptoms after CT (P < 0.01), and OS was directly correlated with chemotherapy response (P < 0.01). HER-2 overexpression was a prognostic factor with reduced OS (P = 0.01). GC protocol was effective and tolerable in objective-responded patients.

摘要

经蒽环类和紫杉类药物治疗的转移性乳腺癌(MBC)的治疗较为复杂。吉西他滨(G)-顺铂(C)联合方案已被用于 MBC 的协同挽救治疗,并且被认为是对具有重要症状和侵袭性内脏疾病的患者的另一种选择。我们分析了 GC 在 AT 预处理 MBC 中的安全性和疗效,以及总生存(OS)和无进展时间(TTP)。49 名患者接受了 IV G 750 mg/m²和 C 30 mg/m²,d1 和 d8 每 3 周一次。每第二个周期和治疗结束时进行反应评估。GC 方案在一半的病例中是一线姑息化疗,中位治疗周期数/患者为 4(2-12)。肺(75.5%)是最常见的转移部位。大多数患者在 85.7%的病例中表现出与化疗相关的临床改善,副作用最小/轻微可耐受。在 34 个月后,平均 OS/TTP 为 13.12/6.6 个月。客观缓解的患者(40.3%)与 CT 后症状改善呈统计学相关(P < 0.01),OS 与化疗反应直接相关(P < 0.01)。HER-2 过表达是降低 OS 的预后因素(P = 0.01)。GC 方案在客观缓解的患者中有效且可耐受。

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