[1]李小峰,孙新宇,张 慧.曲妥珠单抗联合紫杉醇和卡铂治疗人表皮生长因子受体-2阳性乳腺癌的疗效及其对心功能的影响[J].新乡医学院学报,2022,39(4):376-380.[doi:10.7683/xxyxyxb.2022.04.016]
 LI Xiaofeng,SUN Xinyu,ZHANG Hui.Effect of trastuzumab combined with paclitaxel and carboplatin in the treatment of patients with human epidermal growth factor receptor-2-positive breast cancer and its effect on cardiac function[J].Journal of Xinxiang Medical University,2022,39(4):376-380.[doi:10.7683/xxyxyxb.2022.04.016]
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曲妥珠单抗联合紫杉醇和卡铂治疗人表皮生长因子受体-2阳性乳腺癌的疗效及其对心功能的影响
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
39
期数:
2022年4
页码:
376-380
栏目:
临床研究
出版日期:
2022-04-05

文章信息/Info

Title:
Effect of trastuzumab combined with paclitaxel and carboplatin in the treatment of patients with human epidermal growth factor receptor-2-positive breast cancer and its effect on cardiac function
作者:
李小峰1孙新宇1张 慧2
(1.榆林市第一医院肿瘤科,陕西 榆林 719000;2.榆林市第一医院心血管内科,陕西 榆林 719000)
Author(s):
LI Xiaofeng1SUN Xinyu1ZHANG Hui2
(1.Department of Oncology,the First Hospital of Yulin,Yulin 719000,Shaanxi Province,China;2.Department of Cardiovascular Medicine,the First Hospital of Yulin,Yulin 719000,Shaanxi Province,China)
关键词:
乳腺癌曲妥珠单抗人表皮生长因子受体2紫杉醇卡铂心脏毒性
Keywords:
breast cancertrastuzumabhuman epidermal growth factor receptor-2paclitaxelcarboplatincardiotoxicity
分类号:
R737.9
DOI:
10.7683/xxyxyxb.2022.04.016
文献标志码:
A
摘要:
目的 探讨曲妥珠单抗联合紫杉醇、卡铂治疗人表皮生长因子受体-2(HER-2)阳性乳腺癌的临床效果及其对患者心功能的影响。方法 选择2017年1月至2019年1月榆林市第一医院收治的150例HER-2阳性乳腺癌女性患者为研究对象,依据治疗方案将患者分为观察组(n=87)和对照组(n=63)。对照组患者给予紫杉醇和卡铂联合化学治疗,观察组患者给予曲妥珠单抗、紫杉醇和卡铂联合化学治疗。化学治疗后1个月参照实体瘤疗效评价标准评估2组患者的临床疗效,并计算客观缓解率(ORR)和疾病控制率(DCR);采用美国国立癌症研究所制定的不良反应事件通用术语标准评价2组患者治疗期间的不良反应;化学治疗前(T0)、化学治疗1个疗程(T1)、化学治疗2个疗程(T2)、化学治疗结束(T3)及化学治疗结束后1个月(T4)使用心脏超声检查患者左心室射血分数(LVEF);分别于化学治疗前、化学治疗后采用免疫发光法检测血清心肌肌钙蛋白I(cTnI)、氨基末端B型脑钠肽前体(NT-proBNP)水平,采用酶联免疫吸附试验检测血清肌酸激酶同工酶(CK-MB)水平。结果 观察组患者的临床疗效显著优于对照组(Z=3.805,P<0.05);对照组患者的ORR和DCR分别为30.16%(19/63)、65.08%(41/63),观察组患者的ORR、DCR分别为57.47%(50/87)、87.36%(76/87),观察组患者的ORR、DCR显著高于对照组(χ2=10.973、10.567,P<0.05)。治疗期间,2组患者心脏毒性、血小板和白细胞减少、胃肠道反应、脱发、口腔黏膜炎、神经毒性、过敏反应等不良反应发生率比较差异无统计学意义(P>0.05)。2组患者T1、T2、T3、T4时LVEF显著低于T0时,T2、T3、T4时LVEF显著低于T1时,T3、T4时LVEF显著低于T2时(P<0.05);2组患者T4时LVEF有所回升;各时间点2组患者LVEF比较差异均无统计学意义(P>0.05)。化学治疗前2组患者血清cTnI、CK-MB、NT-proBNP水平比较差异无统计学意义(P>0.05);2组患者化学治疗后血清cTnI、CK-MB、NT-proBNP水平显著高于化学治疗前(P<0.05),化学治疗后2组患者血清cTnI、CK-MB、NT-proBNP水平比较差异无统计学意义(P>0.05)。结论 曲妥珠单抗联合紫杉醇和卡铂化学治疗方案可提高HER-2阳性乳腺癌患者的治疗效果,且曲妥珠单抗未增加心脏毒性事件及心脏功能损害。
Abstract:
Objective To investigate the clinical effect of trastuzumab combined with paclitaxel and carboplatin in the treatment of human epidermal growth factor receptor-2 (HER-2)-positive breast cancer and its effect on patients′ cardiac function.Methods A total of 150 female patients with HER-2-positive breast cancer admitted to the First Hospital of Yulin from January 2017 to January 2019 were selected as the research subjects,and the patients were divided into observation group (n=87) and control group (n=63) according to the treatment plan.The patients in the control group were treated with the combined chemotherapy of paclitaxel and carboplatin,and the patients in the observation group were treated with the combined chemotherapy of trastuzumab,paclitaxel and carboplatin.One month after chemotherapy,the clinical effect of patients in the two groups was evaluated according to the response evaluation criteria in solid tumors,and the objective response rate (ORR) and disease control rate (DCR) were calculated.The adverse reactions of patients in the both groups during treatment were evaluated by the common terminology criteria for adverse events established by the National Cancer Institute.The left ventricular ejection fraction (LVEF) was examined by echocardiography at the time points of before chemotherapy (T0),one course of chemotherapy (T1),two courses of chemotherapy (T2),the end of chemotherapy (T3) and one month after chemotherapy (T4).The levels of serum cardiac troponin I (cTnI) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) were detected by immunoluminescence,and the level of serum creatine kinase-MB (CK-MB) was detected by enzyme-linked immunosorbent assay before and after chemotherapy.Results The clinical effect of patients in the observation group was significantly better than that in the control group (Z=3.805,P<0.05).The ORR and DCR of patients in the control group were 30.16% (19/63) and 65.08% (41/63),respectively;and the ORR and DCR of patients in the observation group were 57.47% (50/87) and 87.36% (76/87),respectively.The ORR and DCR of patients in the observation group were significantly higher than those in the control group (χ2=10.973,10.567;P<0.05).During the treatment period,there was no significant difference in the incidence of adverse reactions such as cardiotoxicity,platelet and leukopenia,gastrointestinal reactions,alopecia,oral mucositis,neurotoxicity and anaphylaxis between the two groups (P>0.05).In the two groups,the LVEF of patients at T1,T2,T3 and T4 was significantly lower than that at T0,and the LVEF at T2,T3 and T4 was significantly lower than that at T1,and the LVEF at T3 and T4 was significantly lower than that at T2 (P<0.05).The LVEF of patients in the both groups was recovered at T4.There was no significant difference in LVEF of patients between the two groups at each time point (P>0.05).There was no significant difference in the levels of serum cTnI,CK-MB and NT-proBNP of patients between the two groups before chemotherapy (P>0.05).The levels of serum cTnI,CK-MB and NT-proBNP of patients in the two groups after chemotherapy were significantly higher than those before chemotherapy (P<0.05).There was no significant difference in the levels of serum cTnI,CK-MB and NT-proBNP of patients between the two groups after chemotherapy (P>0.05).Conclusion The combined chemotherapy of trastuzumab,paclitaxel and carboplatin can improve the therapeutic effect of patients with HER-2-positive breast cancer,and the trastuzumab doesn′t increase the cardiotoxic events and cardiac function damage.

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更新日期/Last Update: 2022-04-05