曲妥珠单抗联合卡培他滨或含紫杉类方案治疗HER-2阳性晚期乳腺癌的效果分析

Analysis of the Effect and Prognosis of Trastuzumab Combined with Capecitabine or Taxanes in the Treatment of HER-2 Positive Advanced Breast Cancer

目的探讨曲妥珠单抗联合卡培他滨或含紫杉类方案治疗人表皮生长因子2(HER-2)阳性晚期乳腺癌的临床效果,并分析其对患者预后的影响。方法选取2018年1月-2019年1月在信阳职业技术学院附属医院进行治疗的HER-2阳性晚期乳腺癌新辅助化疗的80例患者,其中43例患者给予曲妥珠单抗联合卡培他滨治疗纳入XH组,37例患者给予曲妥珠单抗联合紫杉醇治疗纳入PH组,随访两年,观察比较两组患者治疗后临床疗效、复发、生存状态。结果XH组客观缓解率(ORR)、疾病控制率(DCR)分别为58.14%、86.05%与PH组的62.16%、86.49%,比较无统计学差异(P>0.05);XH组肿瘤转移发生率为11.63%与PH组的10.81%,比较无统计学差异(P>0.05);XH组复发率为11.63%与PH组的10.81%,比较无统计学差异(P>0.05);XH组6个月、1年、2年生存率分别为97.67%、86.05%、67.44%与PH组的97.30%、86.49%、62.16%,比较无统计学差异(P>0.05);XH组血小板减少发生率明显低于PH组(P<0.05);XH组手足综合症发生率明显高于PH组(P<0.05)。结论曲妥珠单抗联合卡培他滨或紫杉醇方案治疗HER-2阳性晚期乳腺癌近期及远期疗效相近,具有良好预后价值。曲妥珠单抗联合卡培他滨治疗易发生手足综合症,曲妥珠单抗联合紫杉醇易发生血液系统不良反应,应密切关注。

Objective To investigate the clinical effect of trastuzumab combined with capecitabine or taxanes in the treatment of human epidermal growth factor 2(HER-2)positive advanced breast cancer,and to analyze its influence on the prognosis of patients.Methods The subjects were randomized from January 2018 to July 2021 to conduct a clinical and follow-up study on 80 patients with neoadjuvant chemotherapy for HER-2 positive advanced breast cancer selected in our hospital from January 2018 to January 2019.Among them,43 patients who were treated with trastuzumab combined with capecitabine were included in the XH group,37 cases patients treated with trastuzumab combined with paclitaxel were included in the PH group and followed up for two years to observe and compare the clinical efficacy,recurrence,and survival status of the two groups after treatment.Results The objective response rate(ORR)and disease control rate(DCR)of the XH group were 58.14%and 86.05%,respectively,compared with 62.16%and 86.49%of the PH group,there was no significant difference(P>0.05).The incidence of tumor metastasis in the XH group,there was no significant difference between 11.63%and 10.81%in the PH group(P>0.05).The recurrence rate in the XH group was 11.63%compared with 10.81%in the PH group and there was no statistical difference(P>0.05).The survival rates of the XH group at 6 months,1 year,and 2 years were 97.67%,86.05%,and 67.44%,respectively,compared with 97.30%,86.49%,and 62.16%of the PH group,with no statistical difference(P>0.05).The incidence of thrombocytopenia in the XH group was significantly lower than that in the PH group(P<0.05).The incidence of hand-foot syndrome in the XH group was significantly higher than that in the PH group(P<0.05).Conclusion Trastuzumab combined with capecitabine or paclitaxel has similar short-term and long-term curative effects in the treatment of HER-2 positive advanced breast cancer,and has good prognostic value.Trastuzumab combined with capecitabine is prone to hand-foot syndrome,and trastuzumab combined with paclitaxel is prone to blood system adverse reactions,which should be closely followed.