聚乙二醇多柔比星脂质体联合双靶向药物治疗人表皮生长因子受体2阳性乳腺癌患者临床研究

Clinical Study of Pegylated Liposomal Doxorubicin Combined with Dual-Target Drugs in the Treatment of Patients with HER-2-Positive Breast Cancer

目的 探讨聚乙二醇多柔比星脂质体(PLD)联合双靶向药物治疗人表皮生长因子受体2(HER-2)阳性乳腺癌的临床疗效,以及对患者心脏功能的影响。方法 选取医院2018年1月至2020年1月收治的HER-2阳性乳腺癌患者116例,按随机数字表法分为观察组和对照组,各58例。观察组患者给予PLD联合双靶向药物序贯治疗,对照组患者给予表柔比星联合双靶向药物序贯治疗,均以21 d为1个周期,连续治疗4个周期。结果 观察组客观缓解率(ORR)和疾病控制率(DCR)分别为70.69%和86.21%,均显著高于对照组的46.55%和70.69%(P<0.05);治疗后,两组患者心脏功能指标脑利尿钠肽(BNP)、MB型肌酸激酶同工酶(CK-MB)、左室射血分数(LVEF)的水平均无显著差异(P>0.05);观察组和对照组患者心脏毒性发生率相当(6.90%比10.34%,P>0.05);观察组患者脱发发生率为13.79%,显著低于对照组的34.48%(P<0.05);观察组患者的口腔黏膜炎、手足综合征发生率分别为41.40%和39.66%,均显著高于对照组的13.79%和18.97%(P<0.05)。结论 PLD联合双靶向药物序贯治疗HER-2阳性乳腺癌的临床疗效更好,且不增加心脏毒性作用。

Objective To investigate the clinical efficacy of pegylated liposomal doxorubicin(PLD) combined with dual-target drugs in the treatment of human epidermal growth factor receptor 2(HER-2)-positive breast cancer,and its effect on the cardiac function of patients.Methods A total of 116 patients with HER-2-positive breast cancer admitted to the hospital from January 2018 to January 2020 were selected and divided into the observation group and the control group according to the random number table method,with 58 cases in each group. The patients in the observation group were given the sequential treatment of PLD combined with dual-target drugs,while the patients in the control group were given the sequential treatment of epirubicin combined with dual-target drugs. Both groups were treated for four continous cycles with 21 d as a cycle.Results The objective remission rate(ORR) and disease control rate(DCR) in the observation group were 70. 69% and 86. 21% respectively,which were significantly higher than 46. 55% and 70. 69% in the control group respectively(P< 0. 05). After treatment,the cardiac function indexes such as brain natriuretic peptide(BNP),creatinine kinase isoenzyme-MB(CK-MB) and left ventricular ejection fraction(LVEF) levels in the observation group were similar to those in the control group(P > 0. 05). The incidence of cardiotoxicity in the observation group was similar to that in the control group(6. 90% vs. 10. 34%,P > 0. 05). The incidence of alopecia in the observation group was 13. 79%,which was significantly lower than 34. 48% in the control group(P< 0. 05). The incidences of oral mucositis and hand-foot syndrome in the observation group were 41. 40% and 39. 66% respectively,which were significantly higher than 13. 79% and 18. 97% in the control group respectively(P< 0. 05).Conclusion The sequential treatment of PLD combined with dual-target drugs in the HER-2-positive breast cancer is more effective,and it does not increase the cardiotoxicity.