摘要
目的探讨合并慢性肾功能衰竭三阴性乳腺癌患者术后行环磷酰胺联合紫杉类方案化疗的安全性及合并症处理策略。方法回顾性分析2016年6月至2019年12月天津市人民医院收治的8例合并慢性肾功能衰竭三阴性乳腺癌患者的临床及随访资料。结果本组8例患者术后均行标准的环磷酰胺联合紫杉类方案化疗,其中5例为多西他赛75 mg/m^(2)+环磷酰胺600 mg/m^(2),3例为白蛋白紫杉醇260 mg/m^(2)+环磷酰胺600 mg/m^(2)。化疗过程中仅白细胞减少脱发及胃肠道反应等不良事件出现3~4级,发生率分别为25%.25%及12%。4例患者因不良反应调整了用药剂量。除1例患者放弃后续化疗外,其余患者均顺利完成4个周期的化疗。患者在化疗前平均血肌酐水平为(498±63)μmol/L,化疗后为(518±61)pumol/L,差异无统计学意义(t=-2.335,P>0.05)。结论合并慢性肾功能衰竭并非乳腺癌患者术后化疗的禁忌证,针对三阴性乳腺癌患者术后选择标准环磷酰胺联合紫杉类方案并适当调整药物剂量进行辅助化疗是安全的。
Objective To explore the safety of eyelophosphamide combined with taxane chemotherapy in triple-negative breast cancer patients with chronie renal failure and the management strategy of complications.Methods Data of 8 patients with triple-negative breast cancer and chronie renal failure adnmitted to our hospital from Jun 2016 to Dee 2019 were retrospectively analyzed.Results Eight patients received standard cyelophosphamide combined with taxane(TC regimen)chemotherapy after operation,5 of which received docetaxel 75 mg/m^(2)+cyclophosphamide 600 mg/m',and 3 received albumin paclitaxel 260 mg/m^(2)+ceyclophosphamide 600 mg/m^(2),during chemoherapy,only leukopenia,hair loss and gastrointestinal reactions oecurred in grades 3 to 4,and the ineidence was 25%,25%and 12%,respectively.Four patients adjusted the dosage due to adverse reactions.One patient quit,the remaining patients sesfully completed 4 eycles of chemotherapy.The average serum creatinine before chemotherapy was(498±63)μmol/L,and after chemotherapy,it was(518±61)μmo/L(t=-2.335,P>0.05).Conclusions Combined with chronie renal failure is not a contraindication to postoperative chemotherapy for patients with breast cancer.It is safe to choose standard TC regimen and adjust the dose of adjuvant chemotherapy for patients with triple-negative breast cancer.
作者
陶为杰
郝洁
高影
王首骏
解海
张振东
Tao Weijie;Hao Jie;Gao Ying;Wang Shoujun;Xie Hai;Zhang Zhendong(Department of Breast and Thyroid Surgery,Tianjin People's Hospital,Tianjin 300121.China)
出处
《中华普通外科杂志》
CSCD
北大核心
2021年第2期102-105,共4页
Chinese Journal of General Surgery
关键词
乳腺肿瘤
肾功能衰竭
慢性
环磷酰胺
药物疗法
联合
安全
Breast neoplasms
Kidney failure,chronie
Cyelophosphamide
Dug therapy,comhination
Safety
作者简介
通信作者:张振东,Email:zzdl9620810@sina.com,电话:022-27557171。
