曲妥珠单抗联合花青素治疗150例曲妥珠单抗耐药乳腺癌患者的临床疗效评价

Clinical Evaluation of Trastuzumab Combined with Anthocyanin in the Treatment of 150 Patients with Trastuzumab-resistant Breast Cancer

目的总结曲妥珠单抗联合花青素治疗人表皮生长因子-2(HER-2)过度表达的对曲妥珠单抗耐药乳腺癌疗效和安全性。方法选取2016年3月-2018年11月在该院经细胞学证实的HER-2过度表达的150例乳腺癌患者,75例接受曲妥珠单抗治疗方案(对照组),75例接受曲妥珠单抗联合花青素(观察组)方案治疗。参照实体瘤疗效评价标准进行疗效判定,按照美国国立研究院通用毒性标准评价不良反应。结果观察组缓解率为65.33%,控制率为93.33%。对照组缓解率为49.33%,控制率为82.67%。观察组近期疾病控制率与缓解率均高于对照组(χ^2=4.04、3.92,P<0.05)。观察组乳房切除率明显低于对照组(P<0.05),而获取手术率明显高于对照组(P<0.05)。观察组恶心呕吐、肝功能损害的发生率明显低于对照组(P<0.05),观察组和对照组骨髓抑制Ⅰ~Ⅳ度发生率差异无统计学意义(P<0.05)。结论曲妥珠单抗联合花青素可以提高治疗HER-2阳性表达的乳腺癌患者的缓解率和控制率,可明显提升临床疗效,进一步改善患者生活质量。

Objective To summarize the efficacy and safety of trastuzumab combined with anthocyanin in the treatment of trastuzumabresistant breast cancer with overexpression of human epidermal growth factor-2 (HER-2). Methods A total of 150 breast cancer patients with HER-2 overexpression confirmed by our cytology from March 2016 to November 2018 were enrolled. 75 patients received trastuzumab treatment (control group) and 75 received tombuzumab combined with anthocyanin (experimental group) regimen. The efficacy was judged according to the evaluation criteria of solid tumor efficacy, and the adverse reactions were evaluated according to the general toxicity standard of the National Institute of the United States. Results The response rate of the observation group was 65.33%, and the control rate was 93.33%. The response rate of the control group was 49.33%, and the control rate was 82.67%. The disease control rate and remission rate of the observation group were higher than those of the control group(χ^2=4.04, 3.92, P<0.05). The mammectomy rate of the observation group was significantly lower than that of the control group(P<0.05), and the operation rate was significantly higher than that of the control group (P<0.05). The incidence of nausea and vomiting and liver damage in the observation group was significantly lower than that in the control group(P<0.05). There was no statistically significant difference in the incidence of bone marrow suppression Ⅰ to Ⅳ between the observation group and the control group (P<0.05). Conclusion Trastuzumab combined with anthocyanins can improve the remission rate and control rate of breast cancer patients with HER-2 positive expression which can significantly improve clinical efficacy and further improve patients' quality of life.