Ⅰ-Ⅱ期乳腺癌患者保乳术后应用EC-T序贯化疗方案对心脏损伤的影响

Effect of EC-T sequential chemotherapy regimen on heart injury in patients with stageⅠ-Ⅱbreast cancer after breast-conserving surgery

目的:探讨Ⅰ-Ⅱ期乳腺癌患者保乳术后应用EC-T序贯化疗方案对心脏损伤的影响。方法:选取170例乳腺癌保乳术后患者为研究对象,根据治疗方法不同分为观察组和对照组,每组各85例。观察组患者术后接受EC序贯辅助T助化疗(EC-T);对照组术后给予TEC化疗;化疗结束后同时给予大分割放疗。比较两组患者治疗后的毒性反应及心脏损伤指标。结果:观察组患者腹泻、心律失常、心脏毒性反应等级轻于对照组(P<0.05)。两组患者心肌肌钙蛋白Ⅰ(CTNI)、天冬氨酸转移酶(AST)、乳酸脱氢酶(LDH)、肌酸激酶(CK)、左心射血分数(LVEF)、左室短轴缩短率(LVFS)、E/A、血清酸激酶同工酶(CK-MB)水平比较,差异无统计学意义(P>0.05)。观察组患者ECG异常率少于对照组,BNP水平低于对照组(均P<0.05)。结论:EC-T序贯疗法能够减轻对心脏的损害,避免联合足量用药增加的毒性反应。

Objective:To study the effect of EC-T sequential chemotherapy on heart injury in patients with stage I-II breast cancer after breast-conserving surgery.Methods:170 cases of breast cancer patients undergoing breast-conserving surgery were selected as the research objects,and they were divided into observation group(n=85)and control group(n=85)according to different treatment methods.The observation group received postoperative EC sequential adjuvant T-assisted chemotherapy(EC-T),and the control group received postoperative TEC chemotherapy,after the chemotherapy,they were also given hypofractionated radiotherapy.The toxicity and heart damage indexes of the two groups after treatment were compared.Results:The diarrhea,arrhythmia and cardiotoxicity of the observation group were lighter than those of the control group(P<0.05).There was no significant difference in the levels of cardiac troponin I(CTNI),aspartate transferase(AST),lactate dehydrogenation(LDH),creatine kinase(CK),left ventricular ejection fraction(LVEF),left ventricular short axis shortening rate(LVFS),E/A,serum acid kinase isoenzyme(CK-MB)between the two groups(P>0.05).The abnormal rate of ECG in the observation group was lowr than that in the control group(P<0.05),and the BNP level of the observation group was lower than that in the control group(P<0.05).Conclusion:The EC-T sequential therapy can reduce the damage to the heart,and avoid the increased toxicity caused by the combined use of sufficient drugs.