吡咯替尼联合含紫杉醇化疗方案治疗对晚期HER2阳性乳腺癌患者免疫功能及预后的影响

Effects of Pyrotinib Combined with Paclitaxel-based Chemotherapy Regimen on Immune Function and Prognosis in Patients with Advanced HER2-positive Breast Cancer

目的探讨吡咯替尼联合含紫杉醇化疗方案治疗对晚期人表皮生长因子受体-2(HER2)阳性乳腺癌(BC)患者免疫功能及预后的影响。方法选取62例晚期HER2阳性BC患者,采用随机数字表法分为观察组和对照组,各31例。对照组接受含紫杉醇化疗方案治疗,观察组接受吡咯替尼联合含紫杉醇化疗方案联合治疗,均持续治疗12周。治疗后,评估2组疾病控制率(DCR)。比较2组治疗前后T淋巴细胞亚群水平和治疗期间不良反应发生率。应用Kaplan-Meier法分析2组中位无进展生存期和12个月生存率。结果观察组DCR为70.97%,显著高于对照组的45.16%(P<0.05)。治疗后观察组CD3+、CD4+水平高于对照组,CD4+/CD8+水平低于对照组(P<0.05);2组治疗期间肝功能损害、白细胞减少、胃肠道反应、神经毒性反应和皮疹发生率无显著差异(P>0.05)。Kaplan-Meier生存分析,观察组12个月生存率为77.41%,高于对照组的54.83%(χ^(2)=3.946,P<0.05);观察组中位PFS时间为(10.79±0.61)个月,高于对照组的(8.36±0.75)个月(t=4.793,P<0.05)。结论吡咯替尼联合含紫杉醇化疗方案可提高晚期HER2阳性BC患者疾病控制率,改善机体T淋巴细胞免疫功能,延长无进展生存期,安全有效。

Objective To explore the effects of pyrotinib combined with paclitaxel-based chemotherapy regimen on immune function and prognosis in patients with advanced human epidermal growth factor receptor-2(HER2)positive breast cancer(BC).Methods A total of 62 patients with advanced HER2-positive BC were enrolled.According to random number table method,they were divided into the observation group and the control group,31 cases in each group.The control group was given paclitaxel-based chemotherapy regimen,while the observation group was additionally given pyrotinib.After 12 weeks of treatment,disease control rate(DCR)was evaluated.The levels of T lymphocyte subsets before and after treatment,and incidence of adverse reactions during treatment were compared between the two groups.The median progression-free survival(PFS)and 12-month survival rate were analyzed by Kaplan-Meier method.Results DCR in observation group was significantly higher than that in control group(70.97%vs 45.16%,P<0.05).After treatment,levels of CD3+and CD4+in observation group were higher than those in control group,while CD4+/CD8+was lower than that in control group(P<0.05).There was no significant difference in the incidence of adverse reactions(liver function impairment,leukopenia,gastrointestinal reactions,neurotoxic reactions,rash)between the two groups during treatment(P>0.05).Kaplan-Meier survival analysis showed that 12-month survival rate in observation group was higher than that in control group(77.41%vs 54.83%,χ^(2)=3.946,P<0.05),and median PFS was higher than that in control group[(10.79±0.61)months vs(8.36±0.75)months,t=4.793,P<0.05].Conclusion Pyrotinib combined with paclitaxel-based chemotherapy regimen can increase DCR,improve T lymphocyte immune function and prolong PFS in patients with advanced HER2-positive BC,which is safe and effective.