紫杉醇类辅助化疗对HER-2阳性乳腺癌患者生存率影响的研究

Study on the effects of survival rate by using adjuvant chemotherapy including paclitaxel on patients with HER-2 positive breast cancer

目的探讨含紫杉醇类辅助化疗方案对HER-2(表皮生长因子受体2)阳性乳腺癌患者生存率的影响。方法选取2001年5月至2004年10月我院乳腺肿瘤中心HER-2阳性的早期乳腺患者191名,随访至疾病进展,分析她们的临床特征(年龄,手术方式)和病理学特征(激素受体状态,HER-2状态),化疗方案与生存率的关系。结果平均随访29.8个月,总复发转移率12.57%(24/191),平均疾病进展时间27.17个月。其中用只含蒽环类辅助化疗者无病存活率80/96=83.33%,含紫杉醇类辅助化疗者无病存活率97.10%(67/69)(字2=35.67,P<0.001)。其中ER、PR均阴性者99人,用只含蒽环类化疗复发转移24.07%(13/54),含紫杉醇类化疗复发转移2.86%(1/35)(字2=101.10,P<0.0001)。结论含紫杉醇类药物进行术后辅助化疗能增加HER-2阳性乳腺癌患者无病生存获益,尤其是对ER、PR均阴性且HER-2阳性者。

Objective To investigate the effects of survival rate in the use of adjuvant chemotherapy containing paclitaxel on patients with breast cancer of HER-2 positive. Methods From May 2001 to October 2004,191 cases with HER-2 positive breast cancer,were followed-up until disease progress, and the relationship between clinical feature ,pathological type, chemotherapeutic project and survival rate were analyzed retrospectively. Results The mean follow-up is 29.8 months. The total recurrent metastatic rate was 12.57%（24/191）, The mean progressive time of disease was 27.17 months. For the patients received chemotherapy only using contained anthracycline or paclitaxel,the disease-free survival is 83.3% and 97.10% respectively. The ER and PR were negative in 99 cases, and among them, in the patients received emotherapy only using anthracycline or paclitaxel, the recurrent metastatic rate were 24.07% 3/54）and 2.86% （1/35）respectively. （x^2 =101.10,P 〈0.0001）. Conclusions Adjuvant emotherapy containing paclitaxel can improve the disease-free survival of breast cancer with HER-2 positive, especially for the patients with ER and PR negative