曲妥珠单抗并紫杉醇新辅助化疗在HER2阳性晚期局部乳腺癌治疗中的应用研究

摘要

目的 探讨曲妥珠单抗并紫杉醇新辅助化疗治疗人表皮生长因子受体2(HER2)阳性晚期局部乳腺癌(HER2 positive late local breast cancer,HER2-PLLBC)的临床疗效.方法 选取2012年1月至2013年12月自贡市第一人民医院收治的HER2-PLLBC女性患者78例,按照随机数字表法分为试验组(n=39)和对照组(n=39),对照组行曲妥珠单抗治疗,试验组行曲妥珠单抗并多西紫杉醇治疗.比较治疗前后两组血清癌胚抗原(CEA)、糖类抗原153(CA153)、C角蛋白19片段抗原21-1(CYFRA21-1)水平;血清白介素-6(IL-6)、白介素-8(IL-8)及肿瘤坏死因子-α(TNF-α)水平;观察两组患者肿瘤复发情况及不良反应发生率.结果 治疗后,两组患者血清CEA、CA153、CYFRA21-1及IL-6、IL-8、TNF-α水平均降低,试验组血清CEA、CA153、CYFRA21-1及IL-6、IL-8、TNF-α水平均低于对照组,差异有统计学意义(P<0.05);试验组的客观有效率58.97%(23/39)、临床获益率84.62%(33/39)均大于对照组的客观有效率30.77%(12/39)、临床获益率64.10%(25/39);复发率10.26%(4/39)小于对照组的28.21%(11/39),差异有统计学意义(P<0.05).治疗期间,试验组不良反应发生率与对照组比较,差异无统计学意义(P>0.05).结论 曲妥珠单抗并紫杉醇新辅助化疗治疗HER2-PLLBC疗效显著,复发率低,安全可靠.%Objective To study the clinical efficacy of trastuzumab combined with taxol neoadjuvant chemotherapy in treating HER2 positive locally late breast cancer (HER2-PLLBC).Methods A total of 78 female patients with HER2-PLLBC treated in Zigong First People′s Hospital from January of 2012 to December of 2013 were selected and divided into the experiment group (n=39) and the control group (n=39) according to the random number table.The control group was treated with trastuzumab, while the experiment group was treated with trastuzumab combined with docetaxel.The two groups were compared between before and after treatment in the levels of serum carcino embryonic antigens (CEA), carbohydrate Antigen 153 (CA153), cytokeratin 19 fragmentantigen 21-1 (CYFRA21-1), interleukin-6 (IL-6), IL-8 (IL-8) and tumor necrosis factor-α (TNF-α) respectively.The recurrence and adverse reaction of the two groups were also observed and recorded.Results The levels of CEA, CA153, CYFRA21-1, IL-6, IL-8 and TNF-α in both groups were reduced after treatment and those in the experiment group were significantly lower than those in the control group (P<0.05).The objective response rate and clinical benefit rate in the experiment group were 58.97% and 84.62% respectively and higher than those in the control group which were 30.77% and 64.10% respectively.The recurrence rate in the experiment group was 10.26% and significantly lower than that in the control group which was 28.21% (P<0.05).During the treatment period, the difference in the incidence of adverse reactions between the experiment group and control group was not statistically significant (P>0.05).Conclusion Trastuzumab combined with taxol neoadjuvant chemotherapy has significant curative effect with safety, reliability and low recurrence rate in treating HER2-PLLBC.