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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:

35

期数:

2018年6

页码:

517-520

栏目:

临床研究

出版日期:

2018-06-05

文章信息/Info

Title:

Efficacy and safety of trastuzumab combined with paclitaxel for treatment of human epidermal growth factor receptor-2 overexpressing metastatic breast cancer patients

作者:

常　伟; 丁　敏; 周建华; 张明雷

（新乡市第一人民医院肿瘤科，河南　新乡　453000）

Author(s):

CHANG Wei; DING Min; ZHOU Jian-hua; ZHANG Ming-lei

（Department of Oncology，the First People’s Hospital of Xinxiang City，Xinxiang 453000，Henan Province，China）

关键词:

曲妥珠单克隆抗体; 紫杉醇; 人表皮生长因子-2; 转移性乳腺癌

Keywords:

trastuzumab; paclitaxel; human epidermal growth factor-2; metastatic breast cancer

分类号:

R737.9

DOI:

10.7683/xxyxyxb.2018.06.017

文献标志码:

A

摘要:

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。

Abstract:

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 patients 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 disease，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 patients 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.

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更新日期/Last Update: 2018-06-05