曲妥珠单抗联合长春瑞滨治疗HER-2阳性晚期乳腺癌患者的疗效分析

目的探讨曲妥珠单抗联合长春瑞滨治疗HER-2阳性晚期乳腺癌患者的疗效。方法自2010年1月至2014年1月,前瞻性研究我院收治的HER-2阳性的晚期乳腺癌患者120例,将患者随机分为研究组和对照组,每组60例。研究组采用曲妥珠单抗联合长春瑞滨治疗,对照组采用曲妥珠单抗联合卡培他滨治疗。观察两组患者化疗期间相关并发症、生存时间、健康相关的生存质量(SF-36)、实体瘤疗效评价等级。结果与对照组比较,研究组患者部分缓解率显著升高(53.00%vs.28.33%,P=0.005);健康相关的生存质量(SF-36)显著提高(72.95±10.37 vs.65.32±10.40,P<0.01)。随访2年后,研究组共11例患者死亡,对照组共19例患者死亡,两组比较差异无统计学意义(18.33%vs.31.67%,P=0.092)。Wilcoxon检验显示,研究组患者生存期显著高于对照组(P=0.041)。两组患者末梢神经炎、手足综合征、转氨酶升高、胆红素升高、中性粒细胞减少、白细胞减少和消化道症状等差异均无统计学意义(P>0.05)。结论曲妥珠单抗联合长春瑞滨有助于改善晚期乳腺癌患者生存时间,改善其生活质量。

Efficacy of trastuzumab combined with vinorelbine in the treatment of HER-2 positive advanced breast cancer

Objective To investigate the efficacy of trastuzumab combined with vinorelbine in the treatment of patients with HER-2 positive advanced breast cancer.Methods Totally 120 patients admitted to our hospital with positive HER-2 advanced breast cancer from January 2010 to January 2014 were prospectively studied.All patients were randomly assigned into study group and control group,with 60 cases in each group.Study group was given trastuzumab combined with vinorelbine for treatment,while control group received trastuzumab plus capecitabine for treatment.The chemotherapy-related complications,survival time,health-related quality of life (SF-36),and solid tumor efficacy evaluation grade of the two groups were observed.Results Compared with control group,patients in study group got a higher rate of remission (53 ％ vs.28.33 ％,P =0.005),and an elevated level of health-related quality of life (SF-36)(72.95 ± 10.37 vs.65.32 ± 10.40,P ＜ 0.01).After 2 years of follow-up,11 patients died in study group and 19 cases died in control group,and there was no significant difference in 2-year mortality (18.33％ vs.31.67％,P =0.092).Wilcoxon test showed that the survival time of patients in study group was significantly longer than that in control group (P =0.041).Peripheral neuritis,hand foot syndrome,elevated transaminases,elevated bilirubin,neutropenia,leukopenia and gastrointestinal symptoms had no significant difference between the two groups (P ＞ 0.05).Conclusion Trastuzumab combined with vinorelbine is helpful to prolong the survival time and improve the quality of life in patients with advanced breast cancer.