| TP与EC-T化疗方案在三阴性乳腺癌新辅助化疗中疗效与BRCA1突变关系 |
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| 引用本文： | 杨 涛,马秀芬,毛红岩,独晓燕,张 旭,卫翀羿,隆建萍. TP与EC-T化疗方案在三阴性乳腺癌新辅助化疗中疗效与BRCA1突变关系[J]. 现代肿瘤医学, 2022, 0(10): 1776-1780. DOI: 10.3969/j.issn.1672-4992.2022.10.012 |
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| 作者姓名： | 杨 涛 马秀芬 毛红岩 独晓燕 张 旭 卫翀羿 隆建萍 |
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| 作者单位： | 甘肃省妇幼保健院乳腺一科，甘肃 兰州 730050 |
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| 基金项目： | 甘肃省自然科学基金（编号:17JR5RA030） |
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| 摘 要： | 目的:探讨TP与EC-T化疗方案在三阴性乳腺癌新辅助化疗中的疗效，并探索铂类与BRCA1突变关系。方法:选取2016年5月-2020年5月在我院诊断三阴性乳腺癌需新辅助化疗的122例患者，均行BRCA检测，将BRCA1胚系突变患者及未突变患者随机分为两组，一组给予TP（62例）方案新辅助化疗，一组给予EC-T（60例）方案新辅助化疗；按照不同因素分析两组pCR差异。结果:TP组pCR率为56.5%，EC-T组pCR率36.7%，差异有统计学意义（P=0.029）；对于ypT0/is或ypN0 TP组对比EC-T组仍然具有明显优势（分别为64.5% vs 43.3%,P=0.019；69.4% vs 41.7%,P=0.002）；对于BRCA1突变患者，TP组与EC-T组pCR率无统计学差异（50.0% vs 44.4%,P=0.343），对TP组内BRCA1突变与未突变人群pCR率无统计学差异（50.0% vs 57.7%,P=0.224）,对EC-T组内BRCA1突变与未突变人群pCR率无统计学差异（44.4% vs 35.3%,P=0.248）。122例患者的不良反应以 1-2级较常见。EC-T组和TP组患者1-2级恶心/呕吐的发生率分别为71.7％和38.7％(P=0.000 3)，3-4级恶心/呕吐的发生率分别为21.7％和3.2％(P=0.002);TP组和EC-T组患者1-2级血小板减少症的发生率分别为32.3％和8.3％(P=0.001)，3-4级血小板减少症的发生率分别为9.7％和0％(P=0.008)。其他3-4级不良反应少见。结论:TP方案对比EC-T方案明显提高三阴性乳腺癌pCR率，BRCA1是否突变未发现影响铂类方案疗效，整体两组不良反应可以耐受，其中TP组血小板减少发生率较高。
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| 关 键 词： | 三阴性乳腺癌 BRCA1基因突变 TP EC-T 病理完全缓解 |
TP and EC-T chemotherapy regimens in neoadjuvant chemotherapy for triple negative breast cancer and the relationship between platinum and BRCA1 mutation |
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| YANG Tao,MA Xiufen,MAO Hongyan,DU Xiaoyan,ZHANG Xu,WEI Chongyi,LONG Jianping. TP and EC-T chemotherapy regimens in neoadjuvant chemotherapy for triple negative breast cancer and the relationship between platinum and BRCA1 mutation[J]. Journal of Modern Oncology, 2022, 0(10): 1776-1780. DOI: 10.3969/j.issn.1672-4992.2022.10.012 |
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| Authors: | YANG Tao MA Xiufen MAO Hongyan DU Xiaoyan ZHANG Xu WEI Chongyi LONG Jianping |
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| Affiliation: | Department of Breast Surgery，Gansu Provincial Maternity and Child-Care Hospital,Gansu Lanzhou 730050,China. |
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| Abstract: | Objective:To investigate the effect analysis of TP and EC-T chemotherapy regimens in neoadjuvant chemotherapy for triple negative breast cancer,and to explore the relationship between platinum and BRCA1 mutation.Methods:A total of 122 patients were randomly divided into two groups,the BRCA1 mutant group and the BRCA1 non-mutant group,the BRCA1 mutant group received TP(62 cases)regimen of neoadjuvant chemotherapy,and the BRCA1 non-mutant group received EC-T(60 cases)regimen of neoadjuvant chemotherapy.The pCR rate between the two groups were analyzed according to different factors.Results:The pCR rate was 56.5% in the TP group and 36.7% in the EC-T group,the difference was statistically significant(P=0.029).Compared with EC-T group,ypT0/is or ypN0,TP group still had significant advantages(64.5% vs 43.3%,P=0.019;69.4% vs 41.7%,P=0.002).For patients with BRCA1 mutations,there was no statistically significant difference in pCR rate between the TP group and the EC-T group(50.0% vs 44.4%,P=0.343).There was also no statistically significant difference in pCR rate between the TP group and the non-mutant group(50.0% vs 57.7%,P=0.224).There was no statistically significant difference in pCR rate between the BRCA1 mutations and the non-mutant group(44.4% vs 35.3%,P=0.248).The adverse reactions of 122 patients were of grade 1-2.The incidence of grade 1-2 nausea/vomiting was 71.7% in the EC-T group and 38.7% in the TP group(P=0.000 3),and the incidence of grade 3-4 nausea/vomiting was 21.7% and 3.2%(P=0.002),respectively.The incidence of grade 1-2 thrombocytopenia was 32.3% in the TP group and 8.3% in the EC-T group(P=0.001),while that of grade 3-4 thrombocytopenia was 9.7% and 0%(P=0.008).Other grade 3-4 adverse reactions were rare.Conclusion:Compared with EC-T,TP significantly increased the pCR rate of triple negative breast.BRCA1/2 mutation is not found to affect the efficacy of the platinum,and the adverse reactions of the two groups are tolerable,but the TP group had a higher incidence of thrombocytopenia. |
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| Keywords: | triple negative breast cancer BRCA1 mutation TP EC-T pathological complete response |
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