曲妥珠单抗联合新辅助化疗对乳腺癌患者术后临床疗效及相关指标的影响

Effects of Trastuzumab Combined with Neoadjuvant Chemotherapy on Clinical Efficacy and Related Indexes of Breast Cancer Patients after Surgery

目的:探讨曲妥珠单抗联合新辅助化疗对乳腺癌患者术后临床疗效及血清中血管新生因子、乳腺组织中凋亡分子的影响。方法:选择2012年1月-2014年12年在我院接受住院治疗的乳腺癌患者116例作为研究对象,按照随机数表法分为对照组和观察组,各58例。对照组术前给予注射用卡铂100 mg(加入5%葡萄糖注射液稀释至10 mg/m L,再加入500 m L葡萄糖注射液中),于每个化疗周期的第1天ivgtt,200~400 mg/m2;多西他赛注射液于每个化疗周期的第1天ivgtt,75 mg/m2。观察组在对照组基础上加用注射用曲妥珠单抗,第1周剂量4 mg/kg,第2~18周剂量为2 mg/kg,每周1次,ivgtt。3周为1个周期,两组患者均持续治疗6个周期,治疗结束2周后行乳腺癌改良根治术。观察两组患者治疗前后血清血管新生因子水平和乳腺组织凋亡分子水平,并比较两组患者治疗结束后1年时的临床疗效及不良反应发生情况。结果:治疗前,两组患者血清血管新生因子和乳腺组织凋亡分子水平比较,差异均无统计学意义(P>0.05);治疗后,两组患者血清血管新生因子和乳腺组织凋亡分子水平显著降低,且观察组显著低于对照组,差异均有统计学意义(P<0.05)。观察组患者临床有效率为82.76%,显著高于对照组的56.90%,差异有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:曲妥珠单抗联合新辅助化疗有助于提高乳腺癌治疗效果、防止复发,降低血清中血管新生因子及乳腺组织凋亡分子表达水平,且安全性较好。

OBJECTIVE:To investigate the effects of trastuzumab combined with neoadjuvant chemotherapy on clinical efficacy of breast cancer patients,serum angiogenic factors and apoptosis factors of breast tissue.METHODS:A total of116breast cancer in patients were selected from our hospital during Jan.2012-Dec.2014as research object,and then divided into control group and observation group according to random number table,with58cases in each group.Control group was given Carboplatin for injection100mg(added into500mL5%Glucose injection after diluted into10mg/mL),ivgtt,200-400mg/m2on the first day of each chemotherapy cycle;Docetaxel injection ivgtt,75mg/m2on the first day of each chemotherapy cycle.On the basis of control group,observation group was additionally given Trastuzumab for injection,4mg/kg in the first week,2mg/kg in the2nd-8th week,once a week,ivgtt.A treatment course lasted for3weeks,and both groups received6courses of treatment.Both groups received modified radical mastectomy2weeks after treatment.The levels of serum angiogenic factors and apoptosis factors of breast tissue were observed in2groups before and after treatment.Clinical efficacies and the occurrence of ADR were compared between2groups1year after treatment.RESULTS:Before treatment,there was no statistical significance in the levels of serum angiogenic factors and apoptosis factors of breast tissue between2groups(P>0.05).After treatment,the levels of serum angiogenic factors and apoptosis factors of breast tissue were decreased significantly in2groups,and the observation group was significantly lower than the control group,with statistical significance(P<0.05).Clinical response rate of observation group was82.76%,which wassignificantly higher than56.90%of control group,with statistical significance(P<0.05).There was no statistical significance in the incidence of ADR between2groups(P>0.05).CONCLUSIONS:Trastuzumab combined with neoadjuvant chemotherapy is helpful to improve the therapeutic effect with breast cancer,prevent recnrence,and reduce the expression of serum angiogenic factors and apoptosis factors of breast tissue with good safety.