摘要
目的:探讨晚期乳腺癌患者经一线姑息化疗有效后,随诊仅出现肿瘤标志物升高时早期给予二线治疗的临床价值。方法:选取在我院就诊影像学检查有转移病灶,同时伴有肿瘤标志物癌胚抗原(CEA)和(或)糖类抗原15-3(CA-153)升高,经一线姑息化疗有效后,随诊过程中单纯出现肿瘤标志物再次升高的晚期乳腺癌患者42例。根据是否给予二线治疗分为治疗组(20例)和观察组(22例)。主要观察自单纯出现肿瘤标志物升高至影像学出现疾病进展时间(PFSmarker)。结果:晚期乳腺癌一线治疗后,血CEA 及CA-153仍呈下降趋势,随诊过程中单纯出现CEA和(或)CA-153升高时给予二线治疗可以使其再次下降,而观察组则持续升高直至影像学出现肿瘤进展。治疗组PFSmarker为13.65(6~24)个月,观察组为8.18(3~15)个月,两组差异有统计学意义(P <0.05),治疗组明显长于观察组。结论:晚期乳腺癌患者一线治疗有效后,随诊中仅出现肿瘤标志物再次升高,早期给予二线治疗可延缓疾病进展,改善生存。
Objective To evaluate the clinical value of early intervention of second-line treatment for advanced breast cancer patients who experienced elevated tumor marker without any evidence for progress on imaging after effective first-line treatment. Methods We recruited 42 metastatic breast cancer patients experiencing elevated tumor marker (CEA or CA-153) meanwhile, who had merely increased tumor markers again in regular review after effective first-line treatment. Patients were divided into two groups: 20 patients in treatment group were given second-line treatment (palliative chemotherapy); 22 patients in observation group insisted on regular follow-up without any changing of treatment strategy. We mainly evaluated PFSmarker , which was defined as the time between tumor markers increase and disease progression. Results CEA and CA-153 in patients with advanced breast cancer showed a tendency to decrease after first-line chemotherapy , which can be reduced again by second-line treatment while increased in regular review , and the observation group continued to rise until disease progressed. The PFSmarker in treatment group was 13.65 (6 ~ 24) months while that of the observation group was 8.18 (3 ~ 15) months. The difference of PFS between these two groups was statistically significant (P 〈 0.05) and the median time to disease progression in treatment group was significantly longer than that in observation group. Conclusions Early intervention of second-line treatment for advanced breast cancer patients who only experienced elevated tumor marker after effective first-line treatment could slow down disease progression and improve the quality of life.
出处
《实用医学杂志》
CAS
北大核心
2016年第12期1975-1979,共5页
The Journal of Practical Medicine