曲妥珠单抗联合三苯氧胺治疗雌激素受体及人表皮生长因子受体2阳性晚期乳腺癌的效果观察

Effect of trastuzumab combined with endocrine therapy on hormone receptor and human epidermal growthfactor receptor- 2 positive advanced breast cancer

目的探讨曲妥珠单抗联合三苯氧胺治疗雌激素受体（HR）及人表皮生长因子受体2（HER-2）阳性晚期乳腺癌的临床效果。方法选择HR和HER-2阳性晚期乳腺癌患者88例，采用随机数字表法分为两组，各44例，患者均实施规范化疗、放疗、生物治疗、内分泌治疗，对照组使用三苯氧胺治疗，观察组在对照组基础上使用曲妥珠单抗。随访6个月，观察两组治疗前后血清雌二醇（E2）及生活质量变化，比较两组临床效果。结果治疗后，观察组血清E2为（15.3±0.5）pmol/L，低于治疗前的（65.4±2.0）pmol/L及对照组治疗后的（36.9±1.9）pmol/L（t＝70.109、0.240，均P〈0.05）；治疗后，观察组生活质量评分为（35.3±1.1）分，优于治疗前的（81.5±2.3）分及对照组治疗后的（56.6±1.7）分（t＝114.608、66.530，均P〈0.05）；观察组有效率为31.8%，高于对照组的9.1%（χ2＝5.657，P〈0.05）。结论曲妥珠单抗联合三苯氧胺维持治疗，能有效的调节HR和HER-2阳性晚期乳腺癌患者激素水平，改善生活质量，提高临床治疗效果。

ObjectiveTo investigate the effect of trastuzumab combined with endocrine therapy on hormone receptor （HR） and human epidermal growth factor receptor-2 （HER-2） positive advanced breast cancer.MethodsFrom January 2001 to March 2017, 88 patients with HR and HER-2 positive advanced breast cancer were selected.The patients were divided into two groups according to the random number method, with 44 cases in each group.All the patients were treated with routine chemotherapy, radiotherapy and biology therapy.The control group was treated with tamoxifen, and the observation group was treated with trastuzumab on the basis of the control group.All the patients were followed up for 6 months.The changes of serum E2 and quality of life were compared before and after intervention.The clinical effects of the two groups were compared.ResultsThe serum E2 of the observation group was （15.3±0.5）pmol/L, which was lower than that before intervention [（65.4±2.0）pmol/L]and that of the control group after treatment [（36.9±1.9）pmol/L]（t=70.109, 0.240, all P〈0.05）. After the intervention, the quality of life score of the observation group was （35.3±1.1）points, which was higher than that before intervention[（81.5±2.3）points]and that of the control group after treatment [（56.6±1.7）points]（t=114.608, 66.530, all P〈0.05）. The effective rate of the observation group was 31.8%, which was higher than 9.1% of the control group （χ2=5.657, P〈0.05）.ConclusionTrastuzumab combined with endocrine maintenance therapy can effectively regulate the endocrine level of patients with HR and HER-2 positive advanced breast cancer, improve the quality of life and clinical therapeutic effect.