哌柏西利、来曲唑及氟维司群联合用药治疗晚期HR^(+)/HER2^(-)乳腺癌的疗效与安全性观察

Efficacy and safety of piperoxiril,letrozole and fluvestrant in the treatment of advanced HR~+/HER2~- breast cancer

目的:探讨晚期激素受体阳性/人类表皮生长因子受体2阴性(HR^(+)/HER2^(-))乳腺癌采用哌柏西利、来曲唑及氟维司群联合用药的临床效果。方法:本研究选取湖北省肿瘤医院2021年01月至2023年01月治疗的晚期HR^(+)/HER2^(-)乳腺癌患者120例,根据治疗方案将患者分为观察组(n=62)和对照组(n=58),对照组给予来曲唑及氟维司群治疗,观察组给予哌柏西利、来曲唑及氟维司群治疗,观察两组治疗疗效、不良反应及生存情况,同时分析两组治疗前后血清肿瘤标志物、免疫功能差异。结果:观察组客观缓解率(ORR)和疾病控制率(DCR)分别为11.29%和82.26%,明显高于对照组(P<0.05);观察组治疗后癌胚抗原(CEA)、糖类抗原15-3(CA15-3)和糖类抗原125(CA125)分别为(19.49±6.67)ng/mL、(11.54±3.34)U/mL和(43.34±17.28)U/mL,明显低于对照组(P<0.05);观察组治疗后CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+)分别为(49.98±6.90)%、(31.02±7.00)%和(1.18±0.39),高于对照组(P<0.05),而CD8^(+)为(26.38±3.35)%,低于对照组(P<0.05);观察组和对照组不良反应比较差异无统计学意义(P>0.05);观察组中位无进展生存期和总生存期分别为20个月(95%CI:18.87~21.14)和25个月(95%CI:24.41~25.59),明显长于对照组(P<0.05)。结论:哌柏西利、来曲唑及氟维司群治疗晚期HR^(+)/HER2^(-)乳腺癌有较好的临床效果,安全性好,可有效调节肿瘤标志物水平,提高患者预后。

Objective:To investigate the clinical effect of combination of piperacillin,letrozole and fulvestrant on advanced hormone receptor positive/human epidermal growth factor receptor 2 negative(HR^(+)/HER2~-) breast cancer.Methods:This study selected 120 patients with advanced HR^(+)/HER2~- breast cancer who were treated in Hubei Cancer Hospital from January 2021 to January 2023,according to the treatment plan,patients were divided into an observation group(n=62) and a control group(n=58),the control group was treated with letrozole and fluvastatin,the observation group was treated with piperacillin,letrozole,and fluvastatin,the treatment efficacy,adverse reactions,and survival of the two groups were observed,and the differences in serum tumor markers and immune function between the two groups before and after treatment were analyzed.Results:The objective response rate(ORR) and disease control rate(DCR) of the observation group were 11.29% and 82.26%,respectively,which was significantly higher than those of the control group(P<0.05).After treatment,the levels of carcinoembryonic antigen(CEA),carbohydrate antigen 15-3(CA15-3),and carbohydrate antigen 125(CA125) in the observation group were(19.49±6.67)ng/mL,(11.54±3.34)U/mL,and(43.34±17.28)U/mL,respectively,which were significantly lower than those in the control group(P<0.05).After treatment,the CD3^(+),CD4^(+),and CD4^(+)/CD8^(+) levels in the observation group were(49.98±6.90)%,(31.02±7.00)%,and(1.18±0.39)%,respectively,which were higher than those in the control group(P<0.05),while CD8^(+) levels were(26.38±3.35)%,which was lower than those in the control group(P<0.05).There was no statistically significant difference in adverse reactions between the observation group and the control group(P>0.05).The median progression free survival and overall survival in the observation group were 20 months(95%CI:18.87~21.14) and 25 months(95%CI:24.41~25.59),respectively,which was significantly higher than those in the control group(P<0.05).Conclusion:Piperacillin,letrozole and fluvastatin have good clinical effect and safety in the treatment of advanced HR^(+)/HER2~- breast cancer,good safety,which can effectively regulate the level of tumor markers and improve the prognosis of patients.