吉西他滨联合顺铂方案治疗复发性三阴性乳腺癌的疗效观察

The Clinical Observation of Gemcitabine Combined with Cisplatin Regimen on Recurrent Triple-Negative Breast Cancer

目的:探究吉西他滨联合顺铂方案在蒽环、紫杉类药物治疗后复发性三阴性乳腺癌(TNBC)患者中的应用效果。方法:选取2019年1月~2021年1月期间某院收治的81例蒽环、紫杉类药物治疗后复发性TNBC患者作为研究对象,采用随机、单盲试验研究方法,依据随机数字表法分为A组(n=40)和B组(n=41)。A组患者给予注射用盐酸吉西他滨联合卡培他滨片治疗,B组患者给予注射用盐酸吉西他滨联合注射用顺铂治疗。比较两组临床疗效、血清肿瘤标志物[癌胚抗原(CEA)、糖类抗原153(CA153)、糖类抗原125(CA125)]水平变化、生活质量情况[欧洲癌症研究与治疗组织生命质量量表(EORTC QLQ-C30)]、不良反应发生情况及治疗后2年内患者的预后情况。结果:治疗后,B组治疗总有效率(82.93%)高于A组(60.00%,P<0.05)。两组血清CEA、CA153、CA125水平均降低(P<0.05),且B组低于A组(P<0.05)。两组EORTC QLQ-C30评分在疲劳、失眠方面均降低(P<0.05),且B组低于A组(P<0.05);两组EORTC QLQ-C30评分在总体健康方面均升高(P<0.05),且B组高于A组(P<0.05);两组EORTC QLQ-C30评分在恶心呕吐、食欲丧失、便秘方面比较无统计学差异(P>0.05)。两组患者治疗期间不良反应总发生率比较无统计学差异(P>0.05)。B组患者2年内复发率(14.63%)低于A组(40.00%,P<0.05),中位无进展生存期[(6.65±1.45)个月]长于A组[(4.26±1.23)个月,P<0.05],稳定病例数(58.54%)高于A组(30.00%,P<0.05)。结论:与吉西他滨联合卡培他滨相比,吉西他滨联合顺铂治疗方案在蒽环、紫杉类药物治疗后复发性TNBC患者中临床疗效更佳,可有效降低患者血清肿瘤标志物水平,提高生活质量,改善预后。

Objective:To investigate the effect of gemcitabine combined with cisplatin regimen on patients with recurrent triple-negative breast cancer(TNBC)following anthracycline and taxoid drug treatment.Methods:81 patients with recurrent TNBC treated with anthracycline and paclitaxel drugs admitted to a certain hospital between January 2019 and January 2021 were selected as the study subjects.A randomized,single blind trial was conducted,and they were divided into group A(n=40)and group B(n=41)using a random number table method.Group A patients were treated with gemcitabine hydrochloride for injection combined with capecitabine tablets,while group B patients were treated with gemcitabine hydrochloride for injection combined with cisplatin for injection.Compare the clinical efficacy,changes in serum tumor markers[carcinoembryonic antigen(CEA),carbohydrate antigen 153(CA153),carbohydrate antigen 125(CA125)]levels,quality of life[European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30(EORTC QLQ-C30)],incidence of adverse reactions,and prognosis of patients within 2 years after treatment between two groups.Results:After treatment,the total effective rate of treatment in group B(82.93%)was higher than that in group A(60.00%,P<0.05).The serum levels of CEA,CA153,and CA125 in both groups decreased(P<0.05),and group B was lower than group A(P<0.05).The EORTC QLQ-C30 scores of both groups decreased in fatigue and insomnia(P<0.05),and group B was lower than group A(P<0.05);The EORTC QLQ-C30 scores of both groups increased in overall health(P<0.05),and group B was higher than group A(P<0.05);There was no statistically significant difference in the EORTC QLQ-C30 scores between the two groups in terms of nausea,vomiting,loss of appetite,and constipation(P>0.05).There was no statistically significant difference in the total incidence of adverse reactions between the two groups of patients during treatment(P>0.05).The recurrence rate within 2 years in group B patients(14.63%)was lower than that in group A(40.00%,P<0.05),the median progression free survival(6.65±1.45)months was longer than that in group A(4.26±1.23)months(P<0.05),and the number of stable cases(58.54%)was higher than that in group A(30.00%,P<0.05).Conclusion:Compared with gemcitabine combined with capecitabine,the gemcitabine combined with cisplatin treatment regimen has better clinical efficacy in recurrent TNBC patients after anthracycline and paclitaxel treatment.It can effectively reduce the serum tumor marker levels of patients,improve quality of life,and improve prognosis.