曲妥珠单抗联合白蛋白结合型紫杉醇治疗人表皮生长因子受体-2阳性晚期乳腺癌临床观察

Clinical observation of trastuzumab combined with albumin-bound paclitaxel in the treatment of human epidermal growth factor receptor-2 positive advanced breast cancer

目的探讨曲妥珠单抗联合白蛋白结合型紫杉醇治疗人表皮生长因子受体-2(HER-2)阳性晚期乳腺癌患者的近期疗效和生活质量。方法对郑州市第一人民医院2018年8月至2020年3月收治的50例女性HER-2阳性晚期乳腺癌患者进行回顾性分析,分为研究组和对照组2组,每组25例,对照组采用白蛋白结合型紫杉醇治疗,研究组在此基础上联合曲妥珠单抗治疗,比较2组的近期疗效、不良反应及生活质量。结果研究组有效率、疾病控制率分别为68.00%、84.00%,均高于对照组的36.00%、52.00%,差异均有统计学意义(χ^2=5.128,P=0.015;χ^2=5.882,P=0.015)。2组主要不良反应均为Ⅰ、Ⅱ度骨髓抑制、胃肠道反应、肌肉关节痛、脱发、肝功能损害、心肌损伤及发热等,经对症处理后可缓解。研究组社会功能、躯体功能、心理功能、物质功能等生活质量各条目评分及总分均高于对照组,差异均有统计学意义(t=7.494,P<0.001;t=8.944,P<0.001;t=10.431,P<0.001;t=7.889,P<0.001;t=29.781,P<0.001)。结论曲妥珠单抗联合白蛋白结合型紫杉醇在HER-2阳性晚期乳腺癌的治疗中疗效显著,安全性高,并能提高患者生活质量。

Objective To explore the short-term efficacy of trastuzumab combined with albumin-bound paclitaxel in the treatment of patients with human epidermal growth factor receptor-2(HER-2)positive advanced breast cancer and its effect on the quality of life.Methods The 50 patients with HER-2 positive advanced breast cancer admitted in our hospital from May 2018 to March 2020 were selected for retrospective analysis,and they were divided into the study group and the control group,each group with 25 patients.The control group received albumin-bound paclitaxel,the study group received albumin-bound paclitaxel combined with trastuzumab.The short-term efficacy,adverse reactions and the quality of life of patients were compared between the two groups.Results The response rate and the disease control rate were 68.00%and 84.00%in the study group,and were 36.00%and 52.00%in the control group(χ^2=5.128,P=0.015;χ^2=5.882,P=0.015).The main adverse reactions of the two groups were gradeⅠandⅡmyelosuppression,gastrointestinal reactions,muscle and joint pain,alopecia,liver function damage,myocardial injury and fever,which could be relieved after symptomatic treatment.The social function score,physical function score,psychological function score,material function score and total score in the study group were higher than those in the control group(t=7.494,P<0.001;t=8.944,P<0.001;t=10.431,P<0.001;t=7.889,P<0.001;t=29.781,P<0.001).Conclusion Trastuzumab combined with albumin-bound paclitaxel has a significant efficacy and good safety in the treatment of HER-2 positive advanced breast cancer,and can improve the quality of life of patients.