TCbHP、THP及AC-THP3种化疗方案治疗HER2阳性乳腺癌的疗效及生存预后分析  

Efficacy and survival prognosis of TCbHP,THP,and AC-THP in the treatment of HER2-positive breast cancer

作　　者：贺宁 王雪 董雪[1] He Ning;Wang Xue;Dong Xue(Ward for Special Needs,Cancer Hospital Chinese Academy of Medical Sciences,Beijing 100021,China)

机构地区：[1]中国医学科学院肿瘤医院特需病房,北京100021

出　　处：《保健医学研究与实践》2023年第11期67-72,共6页Health Medicine Research and Practice

基　　金：中国癌症基金会“北京希望马拉松”专项基金(LC2017C02)。

摘　　要：目的分析曲妥珠单抗和帕妥珠单抗(HP)联合紫杉类+铂类(TCb HP)、紫杉类单药(THP)及蒽环类序贯紫杉类(AC-THP)3种化疗方案治疗人表皮生长因子受体-2(HER2)阳性乳腺癌的疗效及患者的生存预后情况。方法选取2019年1月—2021年3月中国医学科学院肿瘤医院收治的120例HER2阳性乳腺癌患者为研究对象,按研究对象接受新辅助治疗方案的不同分为3组,分别是TCb HP组(n=52)、THP组(n=47)、AC-THP组(n=21)。比较3组患者基线资料、新辅助治疗疗效、手术后HER2表达情况、化疗期间毒副反应发生情况,并统计术后3组患者的病理完全缓解(p CR)率及2年无病生存率(DFS)。结果3组患者的年龄、月经状态、肿瘤家族史、肿瘤大小、N分期、TNM分期、组织学分级、激素受体状态、手术方式、辅助放疗情况等比较,差异均无统计学意义(P>0.05)。3组患者客观缓解率(ORR)和疾病控制率(DCR)比较,差异均无统计学意义(P>0.05)。3组患者手术后HER2表达情况比较,差异有统计学意义(P<0.05),且TCb HP组患者的HER2阴性表达率(28.85%)明显高于THP组(8.51%)(P<0.016)。化疗期间,3组患者骨髓抑制、肝功能损害、心脏毒性及恶心呕吐等毒副反应发生情况比较,差异均无统计学意义(P>0.05)。术后3组患者的p CR率分别为48.08%、44.68%、47.62%,3组比较,差异无统计学意义(P>0.05);随访2年,3组患者的DFS分别为90.38%、70.21%、80.95%,3组比较,差异有统计学意义(P<0.05)。结论TCbHP、THP及AC-THP 3种化疗方案治疗HER2阳性乳腺癌均有较佳疗效和良好安全性,但TCb HP方案DFS更高,可考虑作为治疗HER2阳性乳腺癌的优选化疗方案。Objective To analyze the efficacy and survival prognosis of trastuzumab and pertuzumab(HP)combined with taxanes+carboplatin(TCbHP),taxanes combined with HP alone(THP)and THP combined with sequential anthracycline and cyclophosphamide(AC-THP)in the treatment of human epidermal growth factor receptor-2(HER2)-positive breast cancer.Methods A total of 120 patients with HER2-positive breast cancer admitted to Cancer Hospital Chinese Academy of Medical Sciences from January 2019 to March 2021 were selected as the study participants and allocated to 3 groups following different neoadjuvant regimens received by the study participants:TCbHP group(n=52),THP group(n=47),and AC-THP group(n=21).The baseline data,efficacy of neoadjuvant therapy,HER2 expression after surgery,and toxicity during chemotherapy were compared among the three groups,and the pathological complete remission(pCR)and 2-year disease-free survival(DFS)rates were counted among the three groups after surgery.Results No significant difference was observed in age,menstrual status,family history of tumors,tumor size,N stage,TNM classification,histological grade,hormone receptor status,surgical methods,and adjuvant radiotherapy among the three groups(P>0.05).No significant differences were found in objective response rate(ORR)and disease control rate(DCR)among the three groups(P>0.05).Significant differences were noted in HER2 expression after surgery among the three groups(P<0.05),and the HER2-negative expression rate of patients in the TCbHP group was significantly higher than that in the THP group(28.85%vs.8.51%;P<0.016).During chemotherapy,no significant differences were observed in the occurrence of toxicities such as myelosuppression,liver function impairment,cardiotoxicity,and nausea and vomiting among the three groups(P>0.05).After operation,the pCR rates of the three groups were 48.08%,44.68%,and 47.62%,respectively,and no significant difference was found among the groups(P>0.05).During the 2-year follow-up,the DFS rates of the three groups were 90.38%,

关 键 词：乳腺癌 HER2阳性 TCbHP THP AC-THP 化疗方案 生存预后 

分 类 号：R737.9[医药卫生—肿瘤]