120例激素受体阳性晚期乳腺癌的临床观察

Clinical observation of 120 cases of advanced breast cancer with hormone receptor-positive

目的观察激素受体阳性晚期乳腺癌的治疗、预后。方法回顾性分析120例采用一线姑息治疗方法治疗的激素受体阳性晚期乳腺癌患者的资料,按照治疗方法的不同分成化疗组(n=81)和内分泌治疗组(n=39),对比两组的治疗效果、不良反应和疾病进展时间(TTP)。结果该类型的晚期乳腺癌患者在一线治疗中采用化疗的占67.5%(81/120),采用内分泌治疗的占32.5%(39/120)。一线化疗组患者疗效:PR为20例,SD为38例,PD为23例,客观缓解率为71.60%(58/81)。一线内分泌组患者的疗效:PR为9例,SD为20例,PD为10例,客观缓解率74.36%(29/39)。化疗组的中位TTP为9.0个月,内分泌组为11.3个月,采用t检验,P=0.041。内分泌组治疗耐受良好,化疗组的血液学毒性、肝功能损害较内分泌组明显增多。结论有更多激素受体阳性的晚期乳腺癌患者在一线治疗时选择化疗,与选择内分泌治疗的患者相比,后者的中位TTP较前者延长。考虑到获益和不良反应,内分泌治疗应得到进一步的重视。

Objective To observe the treatment and prognosis of advanced breast cancer with hormone receptor-positive. Methods The first-line palliative care methods of 120 patients with hormone receptor positive breast cancer were retrospectively analyzed.And the patients were divided into chemotherapy group and endocrine treatment group according to different methods of selection.The treatment effect, adverse reactions and disease progression time between the two groups were compared. Results Of the advanced breast cancer patients with this type, 67.5% （81/120） were treated with chemotherapy in the first-line treatment, and 32.5%（39/120） were treated with endocrine. There were 20 patients with PR, 38 patients with SD and 23 patients with PD in the first-line chemotherapy group,with the objective response rate of 71.60% （58/81）. There were 9 cases of PR, 20 cases of SD and 10 cases of PD in the first-line endocrine group, with the objective response rate of 74.36%（29/39）. The median TYP was 9.0 months in the chemotherapy group and 11.3 months in the endocrine group,（t test, P--O.041）. The treatment was well tolerated in the endocrine group, and hematologic toxicity, liver damage of the chemotherapy group were significantly increased than those of the endocrine group. Conclusion There are more hormone receptor-positive patients with advanced breast cancer who choose chemotherapy in first-line treatment, but the median TIP of the patients treated with chemotherapy is longer than the former compared with patients who choose endocrine therapy. Taking into account the benefits and adverse reactions, endocrine therapy should be given further attention.