多西他赛、曲妥珠单抗联合吡咯替尼治疗晚期HER-2阳性乳腺癌患者的效果

Efficacy of Docetaxel,Trastuzumab Combined with Pyrotinib in the Treatment of Patients with Advanced HER-2 Positive Breast Cancer

目的:分析多西他赛、曲妥珠单抗联合吡咯替尼治疗晚期人表皮生长因子受体(human epidermal growth factor receptor,HER)-2阳性乳腺癌患者的效果。方法:回顾性分析2019年6月—2022年6月厦门大学附属福州第二医院收治的40例晚期HER-2阳性乳腺癌患者的临床资料。根据治疗方法将其分为对照组和观察组,各20例。对照组给予多西他赛、曲妥珠单抗治疗。观察组在对照组基础上给予吡咯替尼。比较两组临床疗效、治疗前后耐药情况、免疫功能、生存质量及不良反应。结果:观察组客观缓解率和疾病控制率均高于对照组,差异有统计学意义(P<0.05)。治疗后,观察组多药耐药蛋白(multidrug resistance protein,P170)、谷胱甘肽-S-转移酶-π、P-糖蛋白阳性率均低于对照组,差异有统计学意义(P<0.05)。治疗后,观察组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均高于对照组,CD8^(+)低于对照组,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)。治疗后,观察组生理状况、社会/家庭状况、情感状况、功能和附加关注评分及总分均高于对照组,差异有统计学意义(P<0.05)。结论:多西他赛、曲妥珠单抗联合吡咯替尼可有效治疗晚期HER-2阳性乳腺癌,对耐药基因表达有抑制作用,可改善免疫功能与生存质量,不增加药物不良反应。

Objective:To analyze the efficacy of Docetaxel,Trastuzumab combined with Pyrotinib in the treatment of patients with advanced human epidermal growth factor receptor(HER)-2 positive breast cancer.Method:The clinical data of 40 patients with advanced HER-2 positive breast cancer admitted to Fuzhou Second Hospital Affiliated to Xiamen University from June 2019 to June 2022 were retrospectively analyzed.According to the treatment method,they were divided into control group and observation group,20 cases in each group.The control group was treated with Docetaxel and Trastuzumab.The observation group was given Pyrotinib on the basis of control group.The clinical efficacy,drug resistance condition,immune function,quality of life before and after treatment and adverse reactions were compared between the two groups.Result:The objective remission rate and disease control rate of the observation group were higher than those of the control group,and the difference was statistically significant(P<0.05).After treatment,the positive rates of multidrug resistance protein(P170),glutathione-S-transferase-πand P-glycoprotein in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After treatment,CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the observation group were higher than those in the control group,and CD8^(+)was lower than those in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).After treatment,the physiological status,social/family status,emotional status,functional and additional attention scores and total scores of the observation group were higher than those of the control group,and the differences were statistically significant(P<0.05).Conclusion:Docetaxel,Trastuzumab combined with Pyrotinib can effectively treat advanced breast cancer with positive HER-2,inhibit the expression of drugresistant genes,improve immune function and quality of life,and do not increase adverse drug reactions.