Breast neoplasms,Liver metastasis,Capecitabine,Intensity-modulated radiotherapy,Efficacy,"/> <div>卡培他滨联合调强放疗治疗乳腺癌肝转移的疗效观察</div>

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中国癌症防治杂志

中国癌症防治杂志 ›› 2017, Vol. 9 ›› Issue (1): 65-68.doi: 10.3969/j.issn.1674-5671.2017.01.13

• 临床经验 • 上一篇    下一篇

卡培他滨联合调强放疗治疗乳腺癌肝转移的疗效观察

  

  1. 台州市肿瘤医院放疗科
  • 出版日期:2017-02-25 发布日期:2017-03-24
  • 基金资助:
    温岭市科技计划资助项目（2014C312080）

Clinical observation of capecitabine combined with intensity-modulated radiotherapy in the treatment of liver metastasis of breast cancer

  1. Department of Radiotherapy,Taizhou Tumor Hospital
  • Online:2017-02-25 Published:2017-03-24

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摘要：

 目的 探讨卡培他滨联合调强放疗（intensity modulated raduation therapy, IMRT）并序贯卡培他滨治疗乳腺癌肝转移的疗效和不良反应。方法 将52例乳腺癌肝转移患者分为卡培他滨联合放疗组27例和卡培他滨治疗组25例。卡培他滨联合放疗组肝转移灶行IMRT，6 MV-X线照射，以95％剂量曲线包绕99%计划靶区，常规分割，2 Gy/次，1次/d，5次/周，共  4～6周，同时给予卡培他滨1 250 mg/m²,2次/d口服同步化疗，放疗结束后给予卡培他滨2 510 mg/m²，2次/d口服，21 d为1个周期。卡培他滨治疗组仅给予卡培他滨2 510 mg/m²，2次/d口服，21 d为1个周期。比较两组疗效及不良反应。结果 卡培他滨联合放疗组和卡培他滨治疗组有效率（RR）分别为74.1%和44%，肿瘤控制率分别为92.6%和68%，两组比较差异均有统计学意义（P>0.05）；中位缓解时间分别为13.6个月和8.9个月，中位生存时间分别为17.4个月和11.7个月，1年生存率分别为85.2%和56.0% (χ2=5.38，P，2年生存率分别为40.7%和16.0% (χ2=3.84，P＜0.05)。不良反应主要有中性粒细胞减少、胃肠道反应、肝功能损伤等，均以Ｉ级、Ⅱ级为主，卡培他滨联合放疗组Ｉ级、Ⅱ级不良反应发生率高于卡培他滨治疗组（P＜0.05），但两组Ⅲ级、Ⅳ级不良反应发生率差异无统计学意义（P>0.05）。结论 卡培他滨联合调强放疗并序贯卡培他滨治疗乳腺癌肝转移远期生存率优于单药卡培他滨维持治疗，不良反应可耐受，是一种有效的治疗方案。

关键词: 乳腺肿瘤, 肝转移, 卡培他滨, 调强放疗, 疗效

Abstract:

Objective To study the efficacy and side effects of capecitabine combined with intensity-modulated radiation therapy （IMRT） against breast cancer that has metastasized to the liver. Methods A total of 52 patients with breast cancer that had metastasized to the liver were divided into 27 cases who were treated with capecitabine and radiation （capecitabine combined with radiotherapy group） and 25 cases who were treated with capecitabine only （capecitabine group）. IMRT was performed on liver metastatic lesions of the capecitabine combined with radiotherapy group，and the 95% dose curve was wrapped around the 99% planned target，with conventional fractionation，2 Gy per time，5 times per week for 4-6 weeks；concurrently，capecitabine therapy （1250 mg/m2） was given 2 times/day orally. After radiotherapy，the patients were treated with capecitabine 2510 mg/m2（2 times/day orally） for a 21-day cycle. The control group was given only capecitabine at 2510 mg/m2（2 times/day orally） for a 21-day cycle. Results Total efficacy rate was 74.1% in the capecitabine combined with radiotherapy group，and 44% in the capecitabine group（P＜0.05）. The tumor control probability （CR+PR+SD） was 92.6% in the capecitabine combined with radiotherapy group and 68% in the capecitabine group（P＜0.05）. The median duration of response in the capecitabine combined with radiotherapy group was 13.6 months，compared to 8.9 months in the capecitabine group（P<0.05）. The median survival time in the capecitabine combined with radiotherapy group was 17.4 months and 11.7 months in the capecitabine group. Respective 1-year survival rates were 85.2% and 56.0%（P<0.05）；2-year survival rates were 40.7% and 16.0%（P<0.05）. Adverse reactions were mainly neutropenia，gastrointestinal reactions，and liver injury，and reactions were grade I and II. Conclusions Capecitabine combined with intensity-modulated radiotherapy for liver metastasis of breast cancer can improve patient survival rate，and adverse reactions can be tolerated.

Key words: Breast neoplasms')">