白蛋白结合型紫杉醇与紫杉醇联合恩度治疗晚期乳腺浸润性小叶癌的疗效与安全性比较

Comparison of the efficacy and safety of albumin-bound paclitaxel and paclitaxel combined with Endo in the treatment of advanced breast invasive lobular carcinoma

目的比较白蛋白结合型紫杉醇与紫杉醇联合恩度治疗晚期乳腺浸润性小叶癌(ILC)的疗效与安全性。方法前瞻性选择2018年1月至2020年6月邯郸市中心医院82例晚期ILC患者作为研究对象,采用随机数字表法分为2组,A组41例患者给予白蛋白结合型紫杉醇联合恩度治疗,B组41例患者给予紫杉醇联合恩度治疗,均治疗3个周期。疗程结束后采用实体瘤疗效评价标准(RECIST)评价2组和A组不同分子分型的近期疗效,采用乳腺癌生存质量量表(FACT-B)评价生存质量,记录治疗期间的不良反应。结果A组总有效率(ORR)、疾病控制率(DCR)分别为53.66%、90.24%,明显高于B组的31.71%、78.05%,差异有统计学意义(P<0.05)。进一步对A组不同分子分型的疗效进行比较显示,Luminal A型ORR、DCR分别为76.47%、100.00%,明显高于Luminal B型的45.45%、90.91%,HER2过表达型的37.50%、87.50%,三阴型的20.00%、60.00%;Luminal B型、HER2过表达型ORR、DCR高于三阴型,差异有统计学意义(P<0.05)。Luminal B型、HER2过表达型ORR、DCR差异无统计学意义(P>0.05)。A组四肢麻木、关节肌肉疼痛的发生率分别为7.32%、12.20%,低于B组的29.27%、36.59%,差异有统计学意义(P<0.05)。2组骨髓抑制、脱发、恶心呕吐、腹泻的发生率比较,差异无统计学意义(P>0.05)。治疗前2组总评分、生理状况评分、功能状况评分比较,差异无统计学意义(P>0.05)。治疗3个周期后,A组总评分、生理状况评分、功能状况评分分别为(121.25±16.84)、(22.89±3.92)、(22.55±3.81)分,明显高于治疗前[(111.06±14.52)、(20.73±4.26)、(20.70±3.76)分],差异有统计学意义(P<0.05)。治疗后A组总评分、生理状况评分、功能状况评分高于B组,差异有统计学意义(P<0.05)。结论白蛋白结合型紫杉醇联合恩度治疗晚期ILC的疗效与安全性均优于紫杉醇联合恩度。

Objective To compare the efficacy and safety of albumin-bound paclitaxel and paclitaxel combined with Endo in the treatment of advanced breast invasive lobular carcinoma(ILC).Methods From January 2018 to June 2020,82 patients with advanced ILC in Handan Central Hospital were selected as the research objects,and they were randomly divided into two groups using a digital table.41 patients in group A were treated with albumin-bound paclitaxel combined with Endo,41 patients in group B were treated with paclitaxel combined with endurance,all of which were treated for 3 cycles.After the course of treatment,the solid tumor efficacy evaluation criteria(RECIST)were used to evaluate the short-term efficacy in two groups and different molecular typing of group A,the breast cancer quality of life scale was used(FACT-B)Evaluation of quality of life,and the toxicity during the treatment period was recorded.Results The total effective rate(ORR),disease control rate(DCR)of group A were 53.66%and 90.24%,respectively,which were significantly higher than 31.71%and 78.05%of group B,the differences were statistically significant(P<0.05).A further comparison of the efficacy of different molecular types in group A showed that the ORR and DCR of Luminal A type were 76.47%and 100.00%,respectively,which were significantly higher than the 45.45%and 90.91%of Luminal B type,and 37.50%,87.50%of the HER2 overexpression type,20.00%,60.00%of the triple-negative type;Luminal B type and HER2 overexpression type ORR and DCR were higher than those of the triple-negative type,and the differences were statistically significant(P<0.05).There was no significant difference in ORR and DCR between Luminal B type and HER2 overexpression type(P>0.05).The incidences of limb numbness and joint muscle pain in group A were 7.32%and 12.20%,respectively,which were lower than 29.27%and 36.59%in group B,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of bone marrow suppression,alopecia,nausea and vomiting,and diarrhea between the two groups(P>0.05).There were no significant differences in total score,physiological status score,and functional status score between the two groups before treatment(P>0.05).After 3 cycles of treatment,the total score,physiological status score,and functional status score of group A were(121.25±16.84),(22.89±3.92),(22.55±3.81)points,respectively,which were significantly higher than those before treatment[(111.06±14.52),(20.73±4.26),(20.70±3.76)points],the differences were statistically significant(P<0.05).Conclusion The efficacy and safety of albumin-bound paclitaxel combined with Endo in the treatment of advanced ILC are better than those of paclitaxel combined with Endo.