曲妥珠单抗联合CAF化疗治疗晚期乳腺癌临床效果观察
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摘要
目的探讨曲妥珠单抗联合CAF化疗治疗晚期乳腺癌临床效果。方法选取自2012年1月至2015年2月武汉大学人民医院收治的132例晚期乳腺癌患者为研究对象,根据治疗方法的不同将所有患者分为A、B两组,每组各66例。A组行CAF化疗方案治疗;B组行曲妥珠单抗联合CAF化疗方案治疗。观察并比较两组患者治疗前后左室射血分数(LVEF)、心肌酶谱相关指标、癌胚抗原(CEA)、血清癌抗原125(CA125)、血清癌抗原15-3(CA15-3)、血管内皮生长因子(VEGF)水平、无进展生存期(PFS)、治疗后1年进展率、临床疗效及不良反应发生情况。结果两组患者治疗后的LVEF、心肌酶谱相关指标比较,差异无统计学意义(P>0.05)。治疗后B组患者的CEA及CA15-3水平显著低于A组,两组比较,差异有统计学意义(P<0.05)。B组患者治疗有效率为92.4%(61/66),显著优于A组的80.3%(53/66),两组比较,差异有统计学意义(P<0.05)。治疗后B组患者的VEGF水平及治疗后1年进展率低于A组,PFS高于A组,两组比较,差异均有统计学意义(P<0.05)。两组患者不良反应发生情况比较,差异无统计学意义(P>0.05)。结论应用曲妥珠单抗联合化疗对晚期乳腺癌进行辅助治疗可提高患者治疗疗效并可延长无进展生存期。
Objective To investigate the the effect of trastuzumab combined with CAF regimen on the treatment of advanced breast cancer.Methods A retrospective study was performed on 132 cases of advanced breast cancer who were admitted from January 2012 to February 2015.According to different treatments,patients were divided into the Group A and Group B,with 66 cases in each group.Patients of Group A were performed CAF regimen,the others in Group B were performed trastuzumab combined with CAF regimen.Left ventricular ejection fraction,myocardial enzyme spectrum,carcinoembryonic antigen,serum cancer antigen 125,serum cancer antigen 15-3,levels of vascular endothelial growth factor,progression-free survival,1-year progression rate after treatment,clinical efficacy and adverse reactions were observed and compared between the two groups before and after treatment.Results After treatment,the levels of cancer embryonic antigen,serum cancer antigen 15-3 and vascular endothelial growth factor in Group B were lower than those in Group A,and the differences between the two groups were statistically significant(P<0.05).The effective rate of Group B was 92.4%(61/66),which was significantly better than 80.3%(53/66)of Group A(P<0.05).The progression-free survival period of Group B was better than that of Group A,and the one-year progression rate after treatment was lower than that of Group A(P<0.05).There was no significant difference in myocardial enzyme profile and adverse reactions between the two groups(P>0.05).Conclusion Via using trastuzumab combined with the CAF regimen in the adjuvant treatment of advanced breast cancer can improve the patient′s treatment efficacy and can improve the patient′s progression-free survival.
Objective To investigate the the effect of trastuzumab combined with CAF regimen on the treatment of advanced breast cancer.Methods A retrospective study was performed on 132 cases of advanced breast cancer who were admitted from January 2012 to February 2015.According to different treatments,patients were divided into the Group A and Group B,with 66 cases in each group.Patients of Group A were performed CAF regimen,the others in Group B were performed trastuzumab combined with CAF regimen.Left ventricular ejection fraction,myocardial enzyme spectrum,carcinoembryonic antigen,serum cancer antigen 125,serum cancer antigen 15-3,levels of vascular endothelial growth factor,progression-free survival,1-year progression rate after treatment,clinical efficacy and adverse reactions were observed and compared between the two groups before and after treatment.Results After treatment,the levels of cancer embryonic antigen,serum cancer antigen 15-3 and vascular endothelial growth factor in Group B were lower than those in Group A,and the differences between the two groups were statistically significant(P<0.05).The effective rate of Group B was 92.4%(61/66),which was significantly better than 80.3%(53/66)of Group A(P<0.05).The progression-free survival period of Group B was better than that of Group A,and the one-year progression rate after treatment was lower than that of Group A(P<0.05).There was no significant difference in myocardial enzyme profile and adverse reactions between the two groups(P>0.05).Conclusion Via using trastuzumab combined with the CAF regimen in the adjuvant treatment of advanced breast cancer can improve the patient′s treatment efficacy and can improve the patient′s progression-free survival.
引文
[1] 姚铁柱,徐志宏,马景涛,等.参麦注射液对乳腺癌患者术后化疗导致心肌损害的保护作用[J].中国实验方剂学杂志,2016,22(7):208-212.
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[11] 张聚良,姚青,陈江浩,等.曲妥珠单抗对HER-2阳性早期乳腺癌外周血循环肿瘤细胞的影响[J].现代肿瘤医学,2013,21(2):279-281.
[12] 魏娜,倪青,戴民,等.术前应用曲妥珠单抗联合新辅助化疗对乳腺癌患者血清中血管新生因子及乳腺组织中凋亡相关分子的影响[J].中国现代医学杂志,2015,25(22):46-49.
[13] Gianni L,Pienkowski T,Im YH,et al.5-year analysis of neoadjuvant pertuzumab and trastuzumab in patients with locally advanced,inflammatory,or early-stage HER2-positive breast cancer(NeoSphere):a multicentre,open-label,phase 2 randomised trial[J].Lancet Oncol,2016,17(6):791-800.
[14] 邵婉婷,付彤,武盼盼,等.Her-2阳性乳腺癌患者曲妥珠单抗联合新辅助化疗的效果评价及其预后影响因素分析[J].吉林大学学报(医学版),2016,42(2):351-357.
[15] Buzdar AU,Valero V,Ibrahim NK,et al.Neoadjuvant therapy with paclitaxel followed by 5-fluorouracil,epirubicin and cyclophosphamide chemotherapy and concurrent trastuzumab in human epidermal growth factor receptor 2-positive operable breast cancer:an update of the initial randomized study population and data of additional patients treated with the same regimen[J].Clin Cancer Res,2007,13(1):228-233.
[2] 佟仲生.抗HER-2靶向治疗乳腺癌在研临床试验进展[J].中国肿瘤临床,2017,44(13):630-634.
[3] 王鹏,刘彩香,诸华健,等.西黄丸联合CAF方案治疗晚期乳腺癌患者的增效减毒效果观察[J].中药药理与临床,2017,33(5):186-189.
[4] 殷科,曹永晋.曲妥珠单抗新辅助化疗表皮生长因子受体2阳性乳腺癌的临床疗效及安全性评价[J].中国临床药理学杂志,2015,(9):725-727.
[5] Valachis A,Mauri D,Polyzos NP,et al.Trastuzumab combined to neoadjuvant chemotherapy in patients with HER2-positive breast cancer:a systematic review and meta-analysis[J].Breast,2011,20(6):485-490.
[6] 刘琪,郭晓龙,左文述,等.乳腺癌术后复发转移间隔与临床病理因素相关性分析[J].中华肿瘤防治杂志,2014,21(7):522-527.
[7] 孙亚华,徐红双,张延勇.自拟参麦养心汤联合磷酸肌酸对接受CAF化疗方案的乳腺癌患者氧自由基及心脏功能的影响[J].现代中西医结合杂志,2017,26(23):2528-2531.
[8] Demonty G,Bernard-Marty C,Puglisi F,et al.Progress and new standards of care in the management of HER-2 positive brease cancer[J].Eur J Cancer,2007,43(3):497-509.
[9] Slamon DJ,Leyland-Jones B,Shak S,et al.Use of chemotherapy plus a monoclonal antibody against HER2 for metastatic breast cancer that overexpresses HER2[J].N Engl J Med,2001,344(11):783-792.
[10] 刘君,杨艳芳,顾林.曲妥珠单抗在HER-2阳性乳腺癌患者新辅助治疗中的应用研究进展[J].中国肿瘤临床,2014,(16):1065-1068.
[11] 张聚良,姚青,陈江浩,等.曲妥珠单抗对HER-2阳性早期乳腺癌外周血循环肿瘤细胞的影响[J].现代肿瘤医学,2013,21(2):279-281.
[12] 魏娜,倪青,戴民,等.术前应用曲妥珠单抗联合新辅助化疗对乳腺癌患者血清中血管新生因子及乳腺组织中凋亡相关分子的影响[J].中国现代医学杂志,2015,25(22):46-49.
[13] Gianni L,Pienkowski T,Im YH,et al.5-year analysis of neoadjuvant pertuzumab and trastuzumab in patients with locally advanced,inflammatory,or early-stage HER2-positive breast cancer(NeoSphere):a multicentre,open-label,phase 2 randomised trial[J].Lancet Oncol,2016,17(6):791-800.
[14] 邵婉婷,付彤,武盼盼,等.Her-2阳性乳腺癌患者曲妥珠单抗联合新辅助化疗的效果评价及其预后影响因素分析[J].吉林大学学报(医学版),2016,42(2):351-357.
[15] Buzdar AU,Valero V,Ibrahim NK,et al.Neoadjuvant therapy with paclitaxel followed by 5-fluorouracil,epirubicin and cyclophosphamide chemotherapy and concurrent trastuzumab in human epidermal growth factor receptor 2-positive operable breast cancer:an update of the initial randomized study population and data of additional patients treated with the same regimen[J].Clin Cancer Res,2007,13(1):228-233.