| Objective: Retrospective analysis of the clinical curative effects, adversereactions and prognostic factors with118anthracycline resistance breast cancer patientsby different scheme chemotherapy.Methods: Collections of118patients from January2006to June2011ofoncology in Dalian Medical University Affiliated First Hospital be attacked byanthracycline resistance metastatic breast cancer. They were divided into4differentgroups according to drug use, among which more than47cases were application of thedocetaxel combine with platinum,31cases of docetaxel combine with capecitabine,28cases of capecitabine, and12cases of docetaxel. The median chemotherapy cycles ofthe4groups were successively5,5,4,3. Observe the short-term curative effect,progression free survival and side-effect of the four groups. Curative effect wasevaluated by Response Evaluation Criteria In Solid Tumors(RECIST),and adversereaction by WHO Cancer drug toxicity assessment standards into0-Ⅳ degrees. Thegeneral information between groups, curative effect and adverse reaction comparisonuse the X2inspection, survival analysis using Kaplan-Meier statistical processing andLog-Rank inspection.Results: The overall disease control rate of the118patients was33.1%, thedisease control rates were78.8%, and the median progression-free survival was5.1months. The objective response rate of docetaxel combine with capecitabine, docetaxelcombine with platinum, docetaxel, and capecitabine were respectively35.5%,36.2%,33.3%, and25%. The disease control rates of the four groups were respectively80.6%,83.0%,75%, and71.4%, all has no statistical difference (P>0.05). Theprogression-free survival of the four groups were5.9,5.8,3.9,4.0months, the difference was statistically significant (P=0.031), among which the progression-freesurvival of docetaxel combine with capecitabine and docetaxel combine with platinumare better than that of docetaxel (P=0.008and P=0.002), there are no difference inprogression-free survival among docetaxel combine with capecitabine, docetaxelcombine with platinum, and capecitabine. In adverse reactions, the I-IV degree bonemarrow restrain incidence of the four groups of were71.0%,82.9%,50.0%,14.3%.I-IVdegree nausea and vomiting rate of the four groups were35.5%,80.9%,33.3%,28.6%.I-IV degree diarrhea rates of the four groups were35.5%,23.4%,16.7%,32.1%. I-IVdegrees hand-foot syndrome rates of the f our groups were41.7%,0.0%,0.0%,37.7%.In addition to the diarrhea, the incidence of bone marrow suppression, nausea andvomiting, and hand-foot syndrome were all have statistically significant (P﹤0.01).Theobjective remission rates and disease control rates of combination chemotherapy groupand single drug group were35.9%,27.5%, and82.1%,72.5%, all has no statisticaldifference (P>0.05). In the two groups the median progression-free survival were5.9months and4.0months, the difference was statistically significant (P=0.018). I-IVdegree bone marrow restrain incidence of the two groups are78.2%and25.0%respectively. I-IV degree nausea and vomiting rates were62.8%,30.0%. Both arestatistically significant (P﹤0.01). The objective response rate of ER(+) was33.0%,HER-2(+)26.9%, HER-2(-)34.8%, luminal A35.5%, luminal B26.7%, HER-2over-expression subtype36.4%, basal-like subtype31.3%, radiotherapy35.9%, noradiotherapy31.6%, endocrine therapy33.3%, no endocrine therapy32.9%, organmetastases34.5%, other parts metastases29.4%. All has no statistical difference (P>0.05).Conclusion:1. The overall objective response rate of118patients withanthracycline resistance metastatic breast cancer was33.1%, the disease control ratewas78.8%, progression-free survival was5.1months.2. There are no difference inobjective response rate and disease control rate among docetaxel combine withcapecitabine, docetaxel combine with platinum, docetaxel and capecitabine.There are nodifference in progression-free survival among docetaxel combine with capecitabine,docetaxel combine with platinum, capecitabine， the progression-free survival ofdocetaxel combine with capecitabine and docetaxel combine with platinum are betterthan that of docetaxel. The objective response rate, disease control rate of combinationchemotherapy group and single drug group were of no difference, progression-freesurvival of combination chemotherapy group has extended.3. The bone marrow suppression, platinum nausea and vomiting of docetaxeland and platinum is heavy,hand-foot syndrome of capecitabine is heavy. The bone marrow suppression rate andnausea and vomiting rate of combination chemotherapy group are higher than that ofsingle drug group.4. The objective response rate of different status of ER/PR/HER-2,breast cancer molecular classification, medical history of radiotherapy endocrinetherapy and transfer part all has no statistical difference (P>0.05). |
