AC-TH与TCH方案对HER-2过表达乳癌新辅助化疗效果比较  

CLINICAL EFFECT OF AC-TH REGIMEN VERSUS TCH REGIMEN AS NEOADJUVANT CHEMOTHERAPY FOR HUMAN EPIDERMAL GROWTH FACTOR RECEPTOR 2-POSITIVE BREAST CANCER

作　　者：马腾[1,2] 史亚飞 马天怡[1] 王海波 MA Teng;SHI Yafei;MA Tianyi;WANG Haibo(Center of Diagnosis and Treatment of Breast Disease,the Affiliated Hospital of Qingdao University,Qingdao 266100,China)

机构地区：[1]青岛大学附属医院乳腺病诊疗中心,山东青岛266100 [2]济宁医学院附属医院乳甲外科

出　　处：《青岛大学学报（医学版）》2021年第3期365-368,共4页Journal of Qingdao University(Medical Sciences)

基　　金：山东省自然科学基金博士基金资助项目(ZR2017-BH061)。

摘　　要：目的比较AC-TH方案(表柔比星、环磷酰胺序贯多西他赛及曲妥珠单抗)与TCH方案(多西他赛、卡铂联合曲妥珠单抗)新辅助化疗对人类表皮生长因子受体2(HER-2)过表达乳癌的近期疗效以及不良反应。方法 AC-TH方案新辅助化疗HER-2阳性乳癌病人35例,TCH方案新辅助化疗HER-2阳性乳癌病人26例,观察并比较两组新辅助化疗效果及不良反应。结果 AC-TH组总有效(OR)率、临床完全缓解(cCR)率、病理完全缓解(pCR)率分别为91.4%、31.4%、25.7%,TCH组OR率、cCR率、pCR率分别为80.8%、50.0%、38.5%,两组比较差异均无显著性(P>0.05)。两组病人骨髓抑制、心脏毒性及其他不良反应差异无显著性(P>0.05);AC-TH组病人化疗后左心室射血分数较TCH组明显下降,差异有统计学意义(t=2.112,P<0.05)。结论 HER-2过表达乳癌的新辅助化疗中,AC-TH方案与TCH方案近期疗效相当,但TCH方案心脏功能损害较小。Objective To investigate the short-term efficacy and toxicity of AC-TH regimen(epirubicin and cyclophosphamide followed by docetaxel and trastuzumab)versus TCH regimen(trastuzumab combined with docetaxel and carboplatin)as the neoadjuvant chemotherapy for human epidermal growth factor receptor 2(HER-2)-positive breast cancer.Methods A total of 35 patients with HER-2-positive breast cancer received neoadjuvant chemotherapy with AC-TH regimen and 26 patients with HER-2-positive breast cancer received neoadjuvant chemotherapy with TCH regimen,and the two groups were compared in terms of the efficacy and toxicity of neoadjuvant chemotherapy.Results There were no significant differences between the AC-TH group and the TCH group in overall response rate,clinical complete response rate,and pathologic complete response rate(91.4%/31.4%/25.7%vs 80.8%/50.0%/38.5%,P>0.05).There were no significant differences in bone marrow suppression,cardioto-xicity,and other toxicities between the two groups(P>0.05),and compared with the TCH group,the AC-TH group had a signi-ficant reduction in left ventricular ejection fraction after chemotherapy(t=2.112,P<0.05).Conclusion As the neoadjuvant chemotherapy for HER-2-positive breast cancer,AC-TH regimen is comparable to TCH regimen in terms of short-term efficacy,while TCH regimen has little cardiac damage.

关 键 词：乳房肿瘤 放化疗 辅助 人类表皮生长因子受体2 治疗结果 

分 类 号：R739.9[医药卫生—肿瘤]