卡培他滨节拍化疗联合氟维司群治疗HR阳性HER-2阴性晚期乳腺癌的短期预后研究

Short-term prognosis of capecitabine metronomic chemotherapy combined with fulvestrant in HR positive/HER-2 negative advanced breast cancer

目的探讨卡培他滨节拍化疗联合氟维司群治疗激素受体(HR)阳性人表皮生长因子受体-2(HER-2)阴性晚期乳腺癌的短期预后。方法60例HR阳性HER-2阴性晚期乳腺癌患者,按治疗方法不同分为对照组和观察组,各30例。对照组患者采用氟维司群治疗,观察组患者采用卡培他滨节拍化疗联合氟维司群治疗。比较两组治疗效果、肿瘤指标、不良反应发生情况及预后。结果观察组客观缓解率(ORR)63.33%、疾病控制率(DCR)96.67%均高于对照组的36.67%、73.33%,差异有统计学意义(P<0.05)。治疗前,两组血清糖类抗原153(CA153)水平比较,差异无统计学意义(P>0.05);治疗16周,两组血清CA153水平低于本组治疗前,且观察组血清CA153水平(22.45±5.30)U/ml低于对照组的(32.31±7.26)U/ml,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。随访1年,观察组无进展生存期(PFS)(7.63±1.27)个月、总生存期(OS)(9.87±1.02)个月均长于对照组的(6.25±1.08)、(8.26±1.25)个月,差异有统计学意义(P<0.05)。结论HR阳性HER-2阴性晚期乳腺癌患者采用卡培他滨节拍化疗联合氟维司群治疗效果显著,可调节肿瘤标志物水平,改善患者短期预后,且有一定的安全性。

Objective To discuss the short-term prognosis of capecitabine metronomic chemotherapy combined with fulvestrant in hormone receptor(HR)positive/human epidermal receptor-2(HER-2)negative advanced breast cancer.Methods A total of 60 patients with HR-positive/HER-2 negative advanced breast cancer were divided into a control group and an observation group according to different treatment methods,with 30 patients in each group.Patients in the control group were treated with fulvestrant,and patients in the observation group were treated with capecitabine metronomic chemotherapy and fulvestrant.The therapeutic effect,tumor index,occurrence of adverse reactions and prognosis of the two groups were compared.Results The objective remission rate(ORR)63.33%and disease control rate(DCR)96.67%in the observation group were higher than 36.67%and 73.33%in the control group,and the differences were statistically significant(P<0.05).Before treatment,there was no statistically significant difference in serum carbohydrate antigen 153(CA153)levels between the two groups(P>0.05).At 16 weeks of treatment,the serum CA153 level in both groups was lower than that before treatment in this group,and the serum CA153 level(22.45±5.30)U/ml in the observation group was lower than(32.31±7.26)U/ml in the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference between the two groups in the comparison of incidence of adverse reactions(P>0.05).At 1 year follow-up,the progression-free survival(PFS)(7.63±1.27)months and overall survival(OS)(9.87±1.02)months in the observation group were longer than(6.25±1.08)and(8.26±1.25)months in the control group,and the differences were statistically significant(P<0.05).Conclusion Capecitabine metronomic chemotherapy combined with fulvestrant has a significant effect on patients with advanced HR-positive/HER-2-negative breast cancer,which can regulate the level of tumor markers and improve the short-term prognosis of patients with certain safety.