白蛋白结合型紫杉醇和多西他赛治疗HER-2阴性乳腺癌患者的临床疗效比较

Clinical effect comparison of albumin-bound paclitaxel and docetaxel in the treatment of HER-2 negative breast cancer

目的研究白蛋白结合型紫杉醇与多西他赛治疗人表皮生长因子受体(HER-2)阴性乳腺癌患者的临床疗效。方法采用前瞻性研究,将池州市人民医院2016年10月至2017年10月间收治的56例HER-2阴性乳腺癌患者纳为研究对象,根据其化疗方案,将其分为A组(白蛋白结合型紫杉醇,n=22)与B组(多西他赛,n=34)。对比两组临床疗效、病理疗效、化疗不良反应及术后3年生存状况。结果A组临床有效率、病理有效率及病理完全缓解(PCR)率分别为72.73%、95.45%和45.45%,B组分别为67.65%、94.12%及44.12%,两组临床有效率、病理有效率及PCR率差异均无统计学意义(P>0.05);化疗过程中,A组3级及以上中性粒细胞减少、白细胞减少及周围感觉神经病变发生率分别为31.82%、27.27%、4.55%,B组分别为64.71%、55.88%和41.18%。A组3级及以上中性粒细胞减少、白细胞减少及周围感觉神经病变发生率均显著低于B组(P<0.05);A组3级以上脱发、胃肠道反应、口腔炎及乏力等并发症发生率分别为50.00%、54.55%、27.27%和36.36%,B组分别为44.18%、41.18%、23.53%和47.06%,两组3级以上脱发、胃肠道反应、口腔炎及乏力发生率差异均无统计学意义(P>0.05);随访3年,两组生存曲线差异无统计学意义(Log Rankχ^2=0.088,P=0.767)。结论白蛋白结合紫杉醇与多西他赛在治疗HER-2阴性乳腺癌中的疗效相似,但nab-P药物毒副反应更低,具有更好的临床应用价值。

Objective To compare the clinical effect of albumin-bound paclitaxel and docetaxel in the treatment of human epidermal growth factor receptor(HER-2)negative breast cancer.Methods 56 patients with HER-2 negative breast cancer in People's Hospital of Chizhou from October 2016 to October 2017 were prospectively included,and divided into two groups according to different chemotherapy regimens.Group A(n=22)received the albumin-bound paclitaxel,while group B(n=34)received the albumin-bound paclitaxel combined with docetaxel.Then the clinical effect was compared between groups.Results The clinical response rate,pathological response rate,and pathological complete response(PCR)rate were 72.73%,95.45%and 45.45%in group A,and those were 67.65%,94.12%and 44.12%in group B,with no significant difference between groups(P>0.05);The incidence rates of neutropenia,leucopenia and peripheral neuropathy above III level during the chemotherapy period were 31.82%,27.27%and 4.55%in group A,which were lower than those(64.71%,55.88%and 41.18%)in group B,with significant difference(P<0.05).The incidence rates of alopecia,gastrointestinal reaction,stomatitis and asthenia had no difference between groups(50.00%vs.44.18%,54.55%vs.41.18%,27.27%vs.23.53%,36.36%vs.47.06%;P>0.05).The survival curve during the 3-year follow-up period had no significant difference between groups(Log Rankχ^2=0.088,P=0.767).Conclusion The efficacy of albumin-bound paclitaxel and docetaxel in the treatment of HER-2 negative breast cancer is similar,while the albumin-bound paclitaxel has lower toxic side effects and has higher clinical value.