曲妥珠单抗联合新辅助化疗治疗乳腺癌的疗效观察

Observation on Efficacy of Trastuzumab Combined with Neoadjuvant Chemotherapy in Treatment of Breast Cancer

目的:探讨曲妥珠单抗联合新辅助化疗治疗乳腺癌的疗效。方法:选取2015年12月—2016年6月宜都市第一人民医院收治的拟行化疗的女性乳腺癌患者80例,以随机数字表法分为观察组和对照组,每组40例。对照组患者给予新辅助化疗,观察组患者在对照组的基础上加用曲妥珠单抗。观察两组患者治疗前后血清血管内皮生长因子和乳腺组织凋亡相关分子水平,比较两组患者的临床疗效和不良反应发生情况。结果:治疗后,两组患者血清血管内皮生长因子水平、环氧酶2、Survivin、Livin、诱骗受体3和半胱氨酸蛋白酶3的表达水平较治疗前明显降低,且观察组患者明显低于对照组,差异均有统计学意义(P<0.05);观察组患者的总有效率和无浸润率分别为87.50%(35/40)、65.00%(26/40),明显高于对照组的65.00%(26/40)、25.00%(10/40),差异均有统计学意义(P<0.05);两组患者恶心呕吐,白细胞、红细胞及血小板计数降低,肾功能异常和肝损伤发生率的差异均无统计学意义(P>0.05)。结论:曲妥珠单抗联合新辅助化疗治疗乳腺癌的疗效显著,可降低血清血管内皮生长因子和乳腺组织凋亡相关分子水平,且不增加不良反应。

OBJECTIVE： To probe into the efficacy of trastuzumab combined with neoadjuvant chemotherapy in treatment of breast cancer. METHODS： 80 female patients with breast cancer undergoing chemotherapy admitted into Yidu the First People＇s Hospital from Dec. 2015 to Jun. 2016 were selected and divided into observation group and control group via random number table,with 40 cases in each. The control group was treated with neoadjuvant chemotherapy,while the observation group was given trastuzumab combined with neoadjuvant chemotherapy. Serum vascular endothelial growth factor（ VEGF） level and apoptosis-related molecules level of breast tissue of two groups were observed,differences in clinical efficacy and incidences of adverse drug reactions between two groups were compared. RESULTS： After treatment,the serum VEGF level,cyclooxygenase-2,Survivin,Livin,capture receptor-3 and the expression level of caspase-3 of both groups were significantly decreased,and those of the observation group were significantly lower than the control group,with statistically significant differences（ P〈0. 05）; the total effective rate and non-infiltration rate of observation group were respectively 87. 50%（ 35/40） and 65. 00%（ 26/40）,which were significantly higher than those of the control group（ 65. 00%,26/40; 25. 00%,10/40）,with statistically significant differences（ P〈0. 05）; there were no statistical significances in the occurring rates of nausea,vomit,reduction of leukocyte,erythrocyte and blood platelet counts,renal dysfunction and liver function impairment between two groups（ P〈0. 05）. CONCLUSIONS： The efficacy of trastuzumab combined with neoadjuvant chemotherapy in treatment of breast cancer is remarkable,which can reduce serum VEGF level and apoptosis-related molecules level of breast tissue,and caused no increase of adverse drug reactions.