摘要
目的探讨曲妥珠单抗联合紫杉醇、卡铂新辅助化疗对人类表皮生长因子受体2基因(humanepidermalgrowthfactorreceptor-2,HER-2)阳性乳腺癌患者疗效,以及对心功能和近期预后的影响。方法选择2016年5月—2018年5月我院收治的106例HER-2阳性乳腺癌患者,按随机数字表法分为观察组54例和对照组52例。对照组术前给予紫杉醇联合卡铂化疗,观察组在对照组基础上术前加用曲妥珠单抗靶向治疗,均21d为1个疗程,连续治疗4个疗程;新辅助化疗后4周给予手术治疗。新辅助化疗后比较两组疗效、心功能指标[左室射血分数(LVEF)、左心室短轴缩短率(LVFS)、二尖瓣舒张早期最大峰值速度/舒张晚期最大峰值速度(E/A)比值]及化疗期间不良反应发生情况;手术治疗结束后随访6个月,比较两组局部复发及转移情况。结果新辅助化疗后,观察组客观缓解率和疾病控制率均显著高于对照组(P<0.05)。新辅助化疗后两组LVEF、LVFS、E/A比值均较治疗前降低(P<0.05),但两组间比较差异无统计学意义(P>0.05)。两组化疗期间消化道反应、血小板减少、中性粒细胞减少、皮疹、脱发、心脏毒性、肝损伤发生率比较差异均无统计学意义(P>0.05)。术后随访6个月,观察组局部复发率、远处转移率均低于对照组(P<0.05)。结论曲妥珠单抗联合紫杉醇、卡铂新辅助化疗可有效提高HER-2阳性乳腺癌患者疗效,降低局部复发率、远处转移率,且对患者心功能无影响,用药安全性较高。
ObjectiveTo investigate the curative effect of trastuzumab combined with paclitaxel and carboplatin as neoadjuvant chemotherapy on human epidermal growth factor receptor-2 (HER-2) positive breast cancer patients, and its effect on cardiac function and short-term prognosis.MethodsA total of 106 patients with HER-2 positive breast cancer admitted to Cangzhou Central Hospital from May 2016 to May 2018 were selected as the study subjects.They were divided into observation group ( n =54) and the control group ( n =52) according to the random number table method.The control group was treated with paclitaxel combined with carboplatin before operation, while the observation group was treated with trastuzumab targeted therapy before operation on the basis of the control group.All the patients received treatment for 21 days as a course of treatment, with four consecutive courses of treatment.Surgical treatment was given 4 weeks after neoadjuvant chemotherapy.After treatment, the curative effect, cardiac function index[left ventricular ejection fraction (LVEF), left ventricular fractional shortening (LVFS), left atrioventricular valve early peak diastolic velocity/late peak diastolic velocity (E/A) ratio] and adverse reactions during chemotherapy were compared between the two groups.ResultsAfter neoadjuvant chemotherapy, the objective remission rate and disease control rate in the observation group were significantly higher than those in the control group, the difference had statistical significance ( P <0.05).After neoadjuvant chemotherapy, the LVEF, LVFS and E/A ratio of the two groups were lower than those before treatment, the difference had statistical significance ( P < 0.05).There were no significant differences in digestive tract reaction, thrombocytopenia, neutropenia, rash, alopecia, cardiotoxicity and liver injury between the two groups during treatment, the difference had no statistical significance ( P >0.05).After 6-month follow-up, the local recurrence rate and distant metastasis rate in the observation group were lower than those in the control group, the difference had statistical significance ( P <0.05).ConclusionTrastuzumab combined with paclitaxel and carboplatin as neoadjuvant chemotherapy can effectively improve the curative effect of HER-2 positive breast cancer patients, and reduce the local recurrence rate and distant metastasis rate.In addition, it has no effect on the patient's cardiac function, with good medication safety.
作者
张晓宇
张辉
杨云云
康晓宁
靳丽君
白杰
刘伟
王合肥
ZHANG Xiao-yu;ZHANG Hui;YANG Yun-yun;KANG Xiao-ning;JIN Li-jun;BAI Jie;LIU Wei;WANG Zun-yi(Department of Thyroid and Mammary Surgery,the Central Hospital of Cangzhou,Hebei 061001,China;Outpatient Department,the Central Hospital of Cangzhou,Hebei 061001,China;Department of Ultrasonography,Cangzhou,the Central Hospital of Cangzhou,Hebei 061001,China)
出处
《临床误诊误治》
2019年第10期51-56,共6页
Clinical Misdiagnosis & Mistherapy
