HER-2阳性乳腺癌辅助化疗后联合序贯曲妥珠单抗与卡培他滨的疗效分析

Efficacy of sequential Trastuzumab combined with Capecitabine after adjuvant chemotherapy for HER-2 positive breast cancer

目的分析HER-2阳性乳腺癌辅助化疗后联合序贯曲妥珠单抗与卡培他滨的疗效。方法选取2013年8月~2016年8月我院收治的220例HER-2阳性乳腺癌患者作为研究对象,采用随机数字表法分为观察组(110例)和对照组(110例)。观察组给予曲妥珠单抗1年联合4个疗程的3周方案卡培他滨口服治疗,对照组给予曲妥珠单抗1年进行治疗。记录并比较两组患者5、10、15、20、24个月的无进展生存率;比较两组患者的无进展生存期(PFS)、总生存期(OS)及不良反应发生情况。结果观察组患者5、10、15、20、24个月的无进展生存率分别为81.82%、69.09%、52.73%、43.64%、36.37%,高于对照组的64.55%、38.18%、31.82%、24.55%、21.82%,差异均有统计学意义(P<0.05)。观察组患者的OS为(17.41±0.43)个月,明显高于对照组的(9.52±1.43)个月,差异有统计学意义(P<0.05)。观察组患者的PFS为(6.51±1.01)个月,明显高于对照组的(4.42±1.32)个月,差异有统计学意义(P<0.05)。两组患者的各种不良反应发生率比较,差异无统计学意义(P>0.05)。结论 HER-2阳性乳腺癌患者在辅助化疗后,在曲妥珠单抗序贯1年的基础上,叠加卡培他滨能提高患者的无进展生存率、PFS和OS,不良反应发生情况与单独使用曲妥珠单抗相当,值得临床推广应用。

Objective To analyze the efficacy of sequential Trastuzumab combined with Capecitabine after adjuvant chemotherapy for HER-2 positive breast cancer. Methods A total of 220 HER-2 positive breast cancer patients admitted to our hospital from August 2013 to August 2016 were selected as the research objects,they were divided into observation group (110 cases) and control group (110 cases) by random number table method. The observation group was treated with Trastuzumab for one year and Capecitabine for three weeks,while the control group was treated with Trastuzumab for one year. The progression-free survival rates at 5,10,15,20 and 24 months were recorded and compared between the two groups. The progression-free survival (PFS),total survival (OS) and adverse reactions were compared between the two groups. Results The 5,10,15,20 and 24 months progression-free survival rates in the observation group were 81.82%,69.09%,52.73%,43.64% and 36.37% respectively,higher than those in the control group (64.55%,38.18%,31.82%,24.55%,21.82%,respectively),the differences were statistically significant (P<0.05). The OS of the observation group was (17.41±0.43) months,which was significantly higher than (9.52±1.43) months of the control group,the difference was statistically significant (P<0.05). The PFS of the observation group was (6.51±1.01) months,which was significantly higher than (4.42±1.32) months of the control group,the difference was statistically significant (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion HER-2 positive breast cancer patients after adjuvant chemotherapy,on the basis of trastuzumab sequential 1 year,superimposed capecitabine can improve the progression-free survival,progression-free survival and overall survival of patients. The incidence of adverse reactions is similar to that of trastuzumab alone,which is worthy of clinical application.