课件：乳腺癌解救化疗.ppt

* * G-CSF use was higher for GD. (Statistical analysis is pending) This is consistent with the higher incidence of G4 neutropenia in GD arm Use of antibiotics and IV antibiotics was higher in GD arm. Again, this is consistent with the higher rate of G4 neutropenia in this arm, and with higher use of G-CSF * * Transfusion of whole blood and RBC was more common in GD arm. For RBC transfusion the difference was statistically highly significant. This is consistent with the significantly higher incidence of G3 and 4 anemia in GD arm. * * The median cycle number was around 7. This is high in this patient population, and suggests good efficacy and tolerance. * * Achieved DI of GEM was highest in GP1 Relative DI of GEM was similar across arms Achieved DI of P was same in GP1 and GP2 Relative DI of P was higher in GP1 * * * 乳腺癌解救化疗若干问题讨论 蒽环类药物治疗失败后的化疗方案如何选择？ 基于病人的转移部位选择化疗药物？ 基于病人基因型或表型选择化疗方案？ 基于化疗药物作用于肿瘤细胞不同的时象选择化疗药物？ 紫杉、蒽环均失败后的化疗方案？ 卡培他滨、长春瑞滨、吉西他滨和铂类在解救化疗中的地位？ 其它：长春碱类、米托蒽醌、培美曲赛 * * This chart was developed from the National Comprehensive Cancer Network guidelines for the treatment of metastatic breast cancer. It is appropriate to divide metastatic disease into hormone receptor positive and hormone receptor negative disease as well as into HER-2 positive and HER-2 negative disease. Chemotherapy should be considered for first-line treatment of metastatic disease in patients who have ER/PR negative (and/or ER/PR positive disease) and are experiencing symptoms (or who have visceral disease), whereas it is more appropriate to exhaust hormonal therapy options for patients who have ER/PR positive disease and who are asymptomatic before looking at chemotherapy options.5 * * * * 病人随机分为健择1250 mg/m2 、第1、8天（30分钟输注）加紫杉醇 175 mg/m2 、第 1天 (3小时输注)组，或单用紫杉醇组（剂量方案与联合治疗相同）16。在使用紫杉醇前进行标准预治疗。每21天为一个治疗周期。 对疾病进行持续治疗，直至疾病进展；每8周对所有部位的肿瘤进行一次评估。16 * * 就既往所接受的治疗而言，两治疗组均衡可比。几乎所有的病人都接受过蒽环类辅助化疗。大约有50％的病人也接受过激素治疗。 * * 总体有效率在健择/紫杉醇组显著较高(40.8% vs 22.1%; p0.0001).10 健择加紫杉醇组病人的中位生存期也较长，但差异并未达到统计学显著