奥沙利铂联合紫杉醇和吉西他滨治疗晚期三阴乳腺癌的效果观察

Efficacy of oxaliplatin combined with paclitaxel and gemcitabine in the treatment of advanced triple negative breast cancer

目的探讨奥沙利铂联合紫杉醇和吉西他滨治疗晚期三阴乳腺癌的临床疗效。方法选取2017年3月至2020年8月间山东第一医科大学附属莱钢医院收治的107例三阴乳腺癌患者作为研究对象,随机分为对照组(53例)和观察组(54例)。对照组患者采用紫杉醇联合吉西他滨化疗方案,观察组患者在对照组的基础上加用奥沙利铂。对比两组的治疗效果,治疗前后黏蛋白1、血管内皮生长因子(VEGF)亚型(VEGF A/VEGF B/VEGF C)水平、生活质量及化疗不良反应发生情况。结果治疗后,研究组总有效率高于对照组(74.1%vs.60.4%),组间对比,差异有统计学意义(P<0.05)。治疗前,两组患者VEGF亚型、黏蛋白1水平、卡氏功能(KPS)评分及生活质量评分对比,差异均无统计学意义(P>0.05);治疗后,两组血清VEGF A、VEGF B、VEGF C及黏蛋白1水平均有显著改善,同时,研究组患者各VEGF亚型及黏蛋白1水平均低于对照组,差异均有统计学意义(均P<0.05)。两组患者KPS评分、生活质量评分对比,差异无统计学意义(P>0.05)。治疗期间两组患者不良反应发生率比较(20.8%vs.22.2%),差异无统计学意义(P>0.05)。结论不能手术的晚期三阴乳腺癌患者采用多种化疗药物联合应用(紫杉醇+吉西他滨+奥沙利铂)可获得更好的效果,有助于降低患者VEGF水平,延缓疾病进展,且不会降低患者生活质量,未增加不良反应,值得临床应用。

Objective To evaluate the efficacy and safety of oxaliplatin combined with paclitaxel and gemcitabine in the treatment of advanced triple negative breast cancer.Methods A total of 107 patients with triple negative breast cancer were selected at Laigang Hospital Affiliated to Shandong First Medical University from March 2017 to August 2020.They were randomly divided into an observation group(54 patients)and a control group(53 patients).Patients in the observation group were treated with oxaliplatin plus paclitaxel and gemcitabine and patients in the control group were treated with paclitaxel combined with gemcitabine.The therapeutic efficacy,mucin1,vascular endothelial growth factor(VEGF)subtypes VEGF A/VEGF B/VEGF C levels,quality of life and the occurrence of chemotherapy-related adverse reactions were compared between the two groups before and after treatment.Results After the treatment,the overall efficacy rate was higher in the experimental group than in the control group(74.1%vs 60.4%)(P<0.05).Before the treatment,there were no significant differences in VEGF subtypes,mucin1 level,Karnofsky performance status(KPS)score and quality of life score between the two groups(P>0.05).After the treatment,the serum levels of VEGF A,VEGF B,VEGF C and mucin1 were significantly improved in the two groups.Meanwhile,the levels of VEGF subtypes and mucin1 were significantly lower in the experimental group than in the control group(all P<0.05).However,there was no significant difference in KPS score and quality of life score between the two groups(P>0.05).Moreover,there was no significant difference in the incidence of adverse reactions between the two groups(20.8%vs 22.2%)(P>0.05).Conclusion For inoperable patients with advanced triple negative breast cancer,the combination of multiple chemotherapy agents including paclitaxel,gemcitabine and oxaliplatin can obtain good efficacy.It helps to reduce the level of vascular endothelial growth factor and delays disease progression without decreasing quality of life and increasing adverse reaction.It is worthy of clinical application.