目的：观察卡培他滨联合曲妥珠单抗治疗Her-2阳性老年转移性乳腺癌的疗效与安全性。方法：32例老年乳腺癌患者（≥65岁）均经病理组织学证实为复发或转移，Her-2阳性，给予卡培他滨1250 mg/m2口服，2次/d，第1~14天；曲妥珠单抗首次负荷剂量8 mg/kg，后续6 mg/kg静点，21 d为一周期，每2周期评价疗效。结果：32例患者均可评价，其中完全缓解（CR）2例（6.2%），部分缓解（PR）10例（31.3%），稳定≥6个月（SD）11例（34.4%），进展（PD）9例（28.1%），总有效率为37.5%（12/32），临床获益率（CR+PR+SD）为71.9%（23/32）；中位疾病进展时间（TTP）8.5个月；主要的毒副反应为手足综合征、腹泻、口腔炎，均可耐受；1例患者出现症状性心力衰竭，停药后改善；无化疗相关死亡。结论：卡培他滨联合曲妥珠单抗治疗Her-2阳性老年转移性乳腺癌疗效确切，毒副反应轻，耐受性良好，是一种安全有效的姑息治疗方案。%Objective:To evaluate the clinical efficacy and safety of capecitabine plus transtuzumab in older patients with Her-2 positive metastatic breast cancer(MBC). Method:Thirty two older patients(≥65 years)with Her-2 over expressing recurrent or metastatic breast cancer(MBC) confirmed by pathology enrolled into the study. The patients received capecitabine 1250 mg/m2 twice daily,1-14 days,combined with intravenous transtuzumab 8 mg/kg body weight on day 1(loading dose),followed by 6 mg/kg every 3 weeks,and were evaluated efficacy every 2 cycles. Result:Complete remission( CR)was 2 cases(6.2%),PR was 10 cases(31.3%),11 cases had stable disease(SD)lasting at least 6 months(34.4%)and 9 cases(28.1%)got progressive disease(PD). The total effective rate was 37.5%(12/32),the clinical benefit response rate(CR+PR+SD)was 71.9%(23/32). The median time to progression(TTP)was 8.5 months. The safety profile of the combination was favorable. The main side effects were hand-foot syndrome,diarrhea and stomatitis which were all tolerable. Only one patient suffered from symptomatic chronic heart failure,which improved after discontinuation of transtuzumab. There were no treatment-related deaths. Conclusion:The combination therapy of capecitabine plus transtuzumab is effective and tolerable for older patients with Her-2 positive MBC,it is a safe and active palliative treatment option.
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