Objective To evaluate the efficacy and safety of the second or third line usage of trastuzumab combined with paclitaxel for treatment of patients with human epidermal growth factor receptor-2(Her-2)overexpressing metastatic breast cancer. Methods A total of 58 patients with Her-2 overexpressing metastatic breast cancer who had been treated by the first and second-line treatment method were selected in the First People's Hospital of Xinxiang City from March 2012 to March 2015. All patients were treated with trastuzumab combined paclitaxel for 6 to 8 cycles,then the efficacy and adverse reactions were evaluated,and the efficacy and adverse reactions between patients with different clinical features were compared. The pa-tients were followed up for three years,and the survival rate was analysed. Results Of the 58 patients,53 patients completed the chemical treatment successfully,including 6 cases of complete remission,24 cases of partial remission,12 cases of stable dis-ease,11 cases of progressive disease,the effective rate was 56. 6％(30/ 53);the 3-year survival rate of patients was 28. 3％(15/53). The effective rate of patients who had not used taxanes was significantly higher than that who had used the taxanes(P <0. 05);the conditions of previous treatment,the estrogen and progesterone receptor and the number of the metastatic sites had no significant effect on the treatment effect(P >0. 05);the 3-year survival rate of patients who had used first-line chemotherapy was significantly higher than that who had used the second-line chemotherapy(P <0. 05);whether use of trastuzumab,the conditond of estrogen and progesterone receptor and the number of the metastatic sites had no significant effect on the 3-year survival rate (P >0. 05). The main adverse reactions of patients were neutrophilic granulocytopenia(75. 5％,40/ 53),anemia(71. 7％,38/53)and thrombocytopenia(50. 9％,27/ 53);there was no statistic difference in the incidence of main adverse reactions in pa-tients with different clinical characteristics(P > 0. 05). Conclusion The second or third-line usage of trastuzumab combined with paclitaxel for treatment of Her-2 overexpressing metastatic breast cancer patients is efficacy and safety. Patients who have not treated with trastuzumab and only received the first-line chemotherapy have a better therapeutic effect.%目的 评价二、三线使用曲妥珠单抗联合紫杉醇治疗人表皮生长因子受体-2(Her-2)过表达转移性乳腺癌的疗效和安全性.方法 选择2012年3月至2015年3月新乡市第一人民医院收治的既往已行一线或二线治疗的Her-2过表达转移性乳腺癌患者58例为研究对象.所有患者给予曲妥珠单抗联合紫杉醇治疗6～8个周期后评价治疗效果和不良反应,并对不同临床特征患者的疗效和不良反应进行比较.随访3 a,统计患者生存率.结果 58例患者中53例顺利完成化学治疗,其中完全缓解6例,部分缓解24例,稳定12例,进展11例,有效率为56.6％(30/53);患者3 a生存率为28.3％(15/53).既往未使用过紫杉类药物患者的有效率显著高于既往使用过者(P<0.05);既往治疗情况、雌孕激素受体情况及转移部位的数量对治疗效果无明显影响(P>0.05);既往已行一线化学治疗患者的3 a生存率显著高于既往已行二线化学治疗者(P<0.05);既往是否使用过紫杉类药物、雌孕激素受体情况及转移部位的数量对患者3 a生存率无明显影响(P>0.05).患者的主要不良反应为中性粒细胞减少(75.5％,40/53)、贫血(71.7％,38/53)和血小板减少(50.9％,27/53).不同临床特征患者的主要不良反应发生率比较差异均无统计学意义(P>0.05).结论 二、三线使用曲妥珠单抗联合紫杉醇对Her-2过表达转移性乳腺癌患者的疗效仍然较高,并且安全、可耐受,对既往未使用紫杉类药物和仅行一线化学治疗患者的疗效更优.
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