Clinical Analysis Of Gemcitabine Combination Chemotherapy In The Treatment Of Advanced Metastatic Breast Cancer

Objective：The aim of this study is to explore the treatment for the advancedmetastatic breast cancer patients by analyzing the efficacy and toxicity of gemcitabinecombination chemotherapy.Methods:87patients with pathologically confirmed advanced metastatic breastcancer were enrolled in1st Affiliated Hospital of Dalian Medical University fromJanuary2006to March2012. All patients was followed until November2012. All the87patients were with complete data. The age of the patients was from to years old, andthe average age was53. The physical condition score (ECOG) of all cases less than2,and the expected survival time was3months; all the simples was confirmed by thedepartment of pathology confirmed advanced metastatic breast cancer; all the patientswas treated with at least one standard treatment, which has been in treatment regimenscontaining anthracycline and (or) paclitaxel drugs, and was found the progression of thecancer after treatment. The patients with Lung metastases was45cases, bone metastasepatients was50cases, patients who had liver metastasis was40cases, lymphnodemetastasis case was9, brain metastasis case was11, and soft tissue metastases was4cases. Pathological type: invasive ductal carcinoma in70cases, other types17cases(including invasive lobular carcinoma in8cases,2cases of ductal carcinoma in situ,lobular carcinoma in situ five cases, mucinous carcinoma in1case, inflammatory breastcancer1case).Survival analysis was performed by Kaplan-Meier method and log-ranktest, P＜0.05was considered as significant by SPSS17.0. To study the difference ofPFS() and OS() between two different gemcitabine combination chemotherapy, twogroups was divided by gemcitabine combined with cisplatin or capecitabine.Result: In the87cases,42patients received the chemotherapy of gemcitabinecombination with cisplatin (GP), and the other cases received the chemotherapy ofgemcitabine combination with capecitabine (GX). There were no significant difference in age, ECOG score, tumor histological type, immunohistochemistry and metastases (P<0.05) between the two groups except that the number of cases. The effective rate andthe disease control rate of the advanced metastatic breast cancer with GP chemotherapywas47.6%,80.9%respectively, and the effective rate and the disease control rate of theadvanced metastatic breast cancer with GP chemotherapy was40%,73.3%respectively.The results showed that the response rate and disease control rate of GP group wereslightly better than the GX group, but there were no significant difference between theGP group and GX group (P>0.05). Until the end of the follow-up, the median PFS ofGP group was3.3months, the median OS was23.5months; the median PFS of GXgroup was4.8months, the median OS was22.6months. The results showed that thePFS of GP group was worse than the GX group, and there was significant differencebetween the GP group and GX group (P <0.05). But there were no significant differencein the OS between the GP group and GX group (P>0.05). There was no death case inthe87patients, but the main of chemotherapy-induced toxicity is bone marrowsuppression and gastrointestinal reactions. The bone marrow suppression rate in the GPgroup was80.9%(34/42) worse than that in the GX group68.9%(31/45). Thegastrointestinal reactions (nausea and vomiting) rates in the GP group was33.3%(14/42), worse than that in the GX group15.6%(7/45). In addition, some patients wasfound hair loss, rash, hand-foot syndrome, fatigue, anemia, ulcers of the oral mucosaand the mild damage of liver and kidney which can be alleviated by the symptomatictreatment. The gastrointestinal reactions rate of the GP group was higher than the GXgroup (P <0.05), but the hand-foot syndrome of GX group was higher than the GPgroup (P <0.05). The other toxicities were no statistically significant differences.Conclusion: In the treatment of advanced metastatic breast cancer patients,compared with gemcitabine combined with cisplatin chemotherapy, the progression freesurvival of gemcitabine plus capecitabine chemotherapy was longer and thechemotherapy toxicity was lighter. So gemcitabine plus capecitabine chemotherapycould make the patients benefit more, compared with gemcitabine combined withcisplatin chemotherapy.