目的 研究注射用培美曲塞二鈉聯(lián)合注射用環(huán)磷酰胺治療復(fù)發(fā)轉(zhuǎn)移性乳腺癌的臨床療效。方法 選取2013年1月-2015年2月榆林市第二醫(yī)院收治的乳腺癌患者68例為研究對象，所有患者隨機(jī)分為對照組和治療組，每組各34例。對照組第1天靜脈滴注注射用培美曲塞二鈉500 mg/m²；第2天靜脈滴注注射用奧沙利鉑100 mg/m²。治療組第1天靜脈滴注注射用培美曲塞二鈉500 mg/m²；第2天靜脈滴注注射用環(huán)磷酰胺500 mg/m²。兩組均以21 d為1個療程，治療2個療程。觀察兩組的臨床療效，比較兩組生活質(zhì)量和不良反應(yīng)發(fā)生情況以及生存率和復(fù)發(fā)率情況。結(jié)果 治療后，對照組和治療組的客觀緩解率分別為52.9%、76.5%，臨床控制率分別為67.6%、88.2%，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組患者的生理狀態(tài)、心理狀態(tài)、軀體功能和社會功能評分均明顯升高，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；且治療組這些觀察指標(biāo)明顯高于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療組的肝腎損傷、貧血、心臟毒性、脫發(fā)的發(fā)生率均明顯低于對照組，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。治療后1年，對照組和治療組生存率分別為61.8%、88.2%，復(fù)發(fā)率分別為23.5%、2.9%，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）；治療后2年，對照組和治療組生存率分別為52.9%、76.5%，復(fù)發(fā)率分別為35.3%、5.9%，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 注射用培美曲塞二鈉聯(lián)合注射用環(huán)磷酰胺治療復(fù)發(fā)轉(zhuǎn)移性乳腺癌具有較好的臨床療效，可提高生活質(zhì)量，改善1、2年期的生存率和復(fù)發(fā)率，安全性較好，具有一定的臨床推廣應(yīng)用價值。

Objective To study the clinical efficacy of Pemetrexed Disodium for injection combined with Cyclophosphamide for injection in treatment of recurrent and metastatic breast cancer. Methods Women (68 cases) with recurrent and metastatic breast cancer in Yulin Second Hospital from January 2013 to February 2015 were randomly divided into control and treatment groups, and each group had 34 cases. Women in the control group were iv administered with Pemetrexed Disodium for injection 500 mg/m² at the first day. Then women in the control group were iv administered with Oxaliplatin for injection 100 mg/m² at the second day. Women in the treatment group were iv administered with Pemetrexed Disodium for injection 500 mg/m² at the first day. Then patients in the treatment group were iv administered with Cyclophosphamide for injection 500 mg/m² at the second day. Patients in two groups were treated for 2 courses, 21 d as a course of treatment. After treatment, the clinical efficacies were evaluated, and quality of life, adverse reaction, survival rates and recurrence rates in two groups were compared. Results After treatment, the objective remission rates in the control and treatment groups were 52.9% and 76.5%, respectively, the clinical control rates in the control and treatment groups were 67.6% and 88.2%, respectively, and there was difference between two groups (P<0.05). After treatment, the scores of physiological status, mental state, somatic function, and social function in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly higher than those in the control group, with significant difference between two groups (P<0.05). The incidence rate of liver and kidney injury, anemia, cardiotoxicity, and alopecia in the treatment group were significantly lower than those in the control group, and there was difference between two groups (P<0.05). One year after treatment, the survival rates in the control and treatment groups were 61.8% and 88.2%, respectively, and the recurrence rates in the control and treatment groups were 23.5% and 2.9%, respectively, and there was difference between two groups (P<0.05). Two years after treatment, the survival rates in the control and treatment groups were 52.9% and 76.5%, respectively, and the recurrence rates in the control and treatment groups were 35.3% and 5.9%, respectively, and there was difference between two groups (P<0.05). Conclusion Pemetrexed Disodium for injection combined with Cyclophosphamide for injection has clinical curative effect in treatment of recurrent and metastatic breast cancer, can enhance the quality of life, improve the survival rate and recurrence rate in 1 and 2 years, with good safety, which has a certain clinical application value.