注射用紫杉醇(白蛋白结合型)联合高压氧治疗乳腺癌化学治疗致周围神经病变临床研究

Clinical Study of Paclitaxel for Injection(Albumin Bound)Combined with Hyperbaric Oxygen in the Treatment of Chemotherapy-Induced Peripheral Neuropathy in Breast Cancer

目的探讨注射用紫杉醇(白蛋白结合型)联合高压氧治疗乳腺癌化学治疗(简称化疗)致周围神经病变(CIPN)的临床疗效。方法选取医院2021年1月至2022年12月收治的乳腺癌患者120例,根据入院时间分为观察组和对照组,各60例。两组患者均予注射用紫杉醇(白蛋白结合型),观察组患者加用高压氧。两组患者均以21 d为1个周期,治疗4个周期。结果观察组的客观缓解率为56.67%,显著高于对照组的36.67%(P<0.05);观察组的病理完全缓解率为53.33%,显著高于对照组的30.00%(P<0.05)。治疗后,两组患者的视觉模拟评分法(VAS)评分均显著低于治疗前(P<0.05),且观察组显著低于对照组(P<0.05);两组患者的双侧腓总神经运动神经传导速度和腓肠神经感觉神经传导速度均显著低于治疗前(P<0.05),但观察组显著高于对照组(P<0.05);两组患者的血清乳腺癌1号基因水平均显著低于治疗前(P<0.05),且观察组显著低于对照组(P<0.05);两组患者的叉头框蛋白A1水平均显著高于治疗前(P<0.05),且观察组显著高于对照组(P<0.05)。观察组和对照组的不良反应发生率相当(8.33%比10.00%,P>0.05)。结论注射用紫杉醇(白蛋白结合型)联合高压氧治疗乳腺癌化疗致CIPN的临床疗效良好,可改善患者化疗所致肌电图平均传导速度和肿瘤抑制基因水平,缓解CIPN疼痛程度,且安全性良好。

Objective To investigate the clinical efficacy of Paclitaxel for Injection(Albumin Bound)combined with hyperbaric oxygen in the treatment of chemotherapy-induced peripheral neuropathy(CIPN)in breast cancer.Methods A total of 120 patients with breast cancer admitted to the hospital from January 2021 to December 2022 were selected and divided into the observation group and the control group according to the time of admission,with 60 cases in each group.The patients in the two groups were treated with Paclitaxel for Injection(Albumin Bound),while the patients in the observation group were treated with hyperbaric oxygen.Both groups were treated for four cycles with 21 d as one cycle.Results The objective remission rate(ORR)in the observation group was 56.67%,which was significantly higher than 36.67%in the control group(P<0.05).The pathological complete remission(pCR)rate in the observation group was 53.33%,which was significantly higher than 30.00%in the control group(P<0.05).After treatment,the visual analogue scale(VAS)score in the two groups was significantly lower than those before treatment(P<0.05),and that in the observation group was significantly lower than that in the control group(P<0.05);the motor conduction velocity(MCV)of the bilateral common peroneal nerve and the sensory conduction velocity(SCV)of the sural nerve in the two groups were significantly lower than those before treatment(P<0.05),and those in the observation group were significantly higher than those in the control group(P<0.05);the serum level of breast cancer 1(BRCA1)in the two groups was significantly lower than that before treatment(P<0.05),and that in the observation group was significantly lower than that in the control group(P<0.05);the level of recombinant forkhead box protein A1(FOXA1)in the two groups was significantly higher than that before treatment(P<0.05),and that in the observation group was significantly higher than that in the control group(P<0.05).The incidence of adverse reactions was comparable between the observation group and the control group(8.33%vs.10.00%,P>0.05).Conclusion Paclitaxel for Injection(Albumin Bound)combined with hyperbaric oxygen has good clinical efficacy and safety in the treatment of chemotherapy-induced CIPN in breast cancer,which can improve the average conduction velocity of electromyography and the level of tumor suppressor genes caused by chemotherapy,and alleviate the pain degree of CIPN.