白蛋白结合型紫杉醇联合卡铂治疗晚期三阴性乳腺癌的疗效评估

Evaluation of the efficacy of albumin-bound paclitaxel combined with carboplatin in treatment of advanced triple-negative breast cancer

目的探讨白蛋白结合型紫杉醇联合卡铂治疗晚期三阴性乳腺癌(TNBC)的近期和远期疗效。方法选取2018-03-01至2020-12-31解放军总医院第三医学中心肿瘤科收治的120例晚期转移性TNBC为研究对象,按随机数字表法平均分为两组,对照组采用白蛋白结合型紫杉醇联合吉西他滨方案治疗,观察组采用白蛋白结合型紫杉醇联合卡铂方案治疗,对比观察两组患者的近期治疗效果、血清肿瘤指标变化、远期治疗效果及不良反应发生情况。结果在随访近期,两组患者的客观缓解率(objective response rate,ORR)及疾病控制率(disease control rate,DCR)对比差异无统计学意义,观察组患者的血清CA125、CA15-3、中期因子(MK)及血小板第4因子(PF4)水平均显著低于对照组(P<0.05),观察组中位无进展生存时间(mPFS)明显长于对照组(4.20个月vs.3.44个月,P<0.05),两组患者的中位总生存时间(mOS)对比差异无统计学意义;在随访远期,观察组的mPFS明显优于对照组(6.77个月vs.5.75个月,P<0.05),观察组患者的mOS明显优于对照组(10.77个月vs.8.78个月,P<0.05)。两组患者的治疗不良反应发生率对比无统计学差异。结论白蛋白结合型紫杉醇联合卡铂的近期、远期治疗效果均优于白蛋白结合型紫杉醇联合吉西他滨,而两种方案的不良反应未见明显差异。

Objective To observe the short and long term efficacy of albumin-bound paclitaxel combined with carboplatin in the treatment of advanced triple-negative breast cancer(TNBC).Methods A total of 120 patients with advanced metastatic TNBC admitted to the Oncology Department of the Third Medical Center of Chinese PLA General Hospital from March 1,2018 to December 31,2020 were selected as the research objects.They were divided into two groups according to the method of random number.The control group was treated with albumin-bound paclitaxel combined with gemcitabine regimen,while the observation group was treated with albumin-bound paclitaxel combined with carboplatin regimen.The short-term treatment effect,changes of serum tumor indexes,long-term treatment effect and incidence of adverse reactions were compared between the two groups.Results During the short-term follow-up,there was no significant difference in objective response rate(ORR)and disease control rate(DCR)between the two groups(P<0.05).Serum CA125,CA15-3,MK and PF4 in the observation group were significantly lower than those in the control group,and the median progression-free survival time(mPFS)in the observation group was significantly longer than that in the control group(4.20 months vs.3.44 months,P<0.05),there was no significant difference in mOS between the two groups.In the long-term follow-up,mPFS of the observation group was significantly better than that of the control group(6.77 months vs.5.75 months,P<0.05),and mOS of the observation group was significantly better than that of the control group(10.77 months vs.8.78 months,P<0.05).There was no significant difference in adverse reactions between the two groups.Conclusions The short-term and long-term efficacy of albumin-bound paclitaxel combined with carboplatin is due to the combination of albumin-bound paclitaxel and gemcitabine,and there is no significant difference in adverse reactions between the two kinds of treatment.