新辅助化疗联合PD-1抑制剂治疗三阴性乳腺癌的临床疗效  

Clinical efficacy of neoadjuvant chemotherapy combined with PD-1 inhibitor in the treatment of triple negative breast cancer

作　　者：张晓宇 任悦 刘伟[1] 苗彦玲[3] 张辉 靳丽君 张恒乐 康晓宁[3] 白杰[1] 王遵义[1] ZHANG Xiaoyu;REN Yue;LIU Wei;MIAO Yanling;ZHANG Hui;JIN Lijun;ZHANG Hengle;KANG Xiaoning;BAI Jie;WANG Zunyi(Department of Thyroid and Breast SurgeryⅢ,Cangzhou Central Hospital,Cangzhou 061000,China;Graduate School,Hebei Medical University;Department of UltrasoundⅡ,Cangzhou Central Hospital)

机构地区：[1]沧州市中心医院甲乳外三科,061000 [2]河北医科大学研究生院 [3]沧州市中心医院超声二科

出　　处：《天津医药》2023年第8期847-850,共4页Tianjin Medical Journal

基　　金：河北省医学科学研究课题(20220400)。

摘　　要：目的探讨新辅助化疗联合PD-1抑制剂治疗三阴性乳腺癌的临床疗效及其对免疫功能的影响。方法将80例三阴性乳腺癌患者随机分为对照组和观察组,每组40例。对照组接受多柔比星脂质体^(+)环磷酰胺^(+)白蛋白紫杉醇(AC-T)序贯化疗,观察组在对照组的基础上联合PD-1抑制剂治疗。所有患者完成免疫治疗及新辅助化疗3周后无手术禁忌证,均行乳腺癌改良根治术。比较2组患者的生活质量、临床疗效、手术时间、术中出血量、免疫指标及不良反应。结果治疗后,观察组生活质量评分高于对照组(84.55±6.09vs.75.93±6.12,P<0.05)。治疗8个周期后,观察组完全缓解率(CRR)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)、IgG、IgA和IgM水平均优于对照组(P<0.05)。观察组手术时间[(43.25±6.85)min vs.(82.53±8.53)min]和术中出血量[(136.52±8.74)mL vs.(241.63±8.32)mL]均少于对照组(P<0.05);2组不良反应发生率差异无统计学意义(P>0.05)。结论三阴性乳腺癌采用新辅助化疗联合PD-1抑制剂治疗可以有效改善患者免疫功能和生活质量,保证临床治疗的安全性。Objective To investigate the clinical efficacy of neoadjuvant chemotherapy combined with PD-1 inhibitor in the treatment of triple negative breast cancer and its effect on immune function.Methods Eighty patients with triple negative breast cancer were randomly divided into the control group and the observation group,with 40 cases in each group.The control group received sequential chemotherapy of doxorubicin liposome^(+)cyclophosphamide^(+)albumin paclitaxel(AC-T),and the observation group was treated with PD-1 inhibitor on the basis of the control group.The quality of life,clinical efficacy,operation time,intraoperative blood loss,immune function and adverse reactions were compared between the two groups.Results After treatment,the SF-36 score was significantly higher in the observation group(84.55±6.09)than that of the control group(75.93±6.12,P<0.05).After 8 courses of treatment,the complete response rate(CRR),CD4^(+),CD8^(+),CD4^(+)/CD8^(+),immunoglobulin IgG,IgA and IgM levels were significantly better in the observation group than those in the control group(P<0.05).The operative time[(43.25±6.85)min vs.(82.53±8.53)min]and intraoperative bleeding[(136.52±8.74)mL vs.(241.63±8.32)mL]were significantly decreased in the observation group than those of the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Neoadjuvant chemotherapy combined with PD-1 inhibitor in the treatment of triple negative breast cancer can improve the immune function and quality of life of patients,and ensure the safety of clinical treatment.

关 键 词：免疫检查点抑制剂 放化疗 辅助 三阴性乳腺癌 生活质量 免疫 主动 

分 类 号：R737.9[医药卫生—肿瘤]