槐耳颗粒联合免疫治疗用于晚期三阴性乳腺癌解救治疗的临床分析  

Clinical Analysis on Huaier Granules Combined with Immunotherapy for Rescue Treatment of Advanced Triple-Negative Breast Cancer

作　　者：殷雨来 赵春智 张嘉澍 张晓宇 YIN Yu-lai;ZHAO Chun-zhi;ZHANG Jia-shu;ZHANG Xiao-yu(Cangzhou Central Hospital Affiliated to Hebei Medical University,Cangzhou 061000 Hebei,China;Graduate School of Hebei University of Chinese Medicine,Shijiazhuang 050299 Hebei,China;Department of Thyroid and Breast SurgeryⅡ,Hejian Hospital of Traditional Chinese Medicine,Cangzhou 061000 Hebei,China;Department of Thyroid and Breast SurgeryⅢ,Cangzhou Central Hospital,Cangzhou 061000 Hebei,China)

机构地区：[1]河北医科大学附属沧州市中心医院,河北沧州061000 [2]河北中医药大学研究生学院,河北石家庄050299 [3]河间市中医院甲状腺乳腺外二科,河北沧州061000 [4]沧州市中心医院甲状腺乳腺外三科,河北沧州061000

出　　处：《中医肿瘤学杂志》2024年第2期33-41,共9页Journal of Oncology in Chinese Medicine

基　　金：沧州市科技计划项目(编号:222106141);河北省医学科学研究课题(编号:20220400);河北省中医药科研计划项目(编号:2020521)。

摘　　要：目的探究槐耳颗粒联合免疫治疗用于晚期三阴性乳腺癌解救治疗的临床获益及安全性。方法收集2019年11月至2021年12月期间就诊于沧州市中心医院的PD-L1表达阳性的晚期三阴性乳腺癌患者67例进行回顾性分析,按照所接受的治疗方案不同分为对照组(n=33)和观察组(n=34)。对照组患者采用卡瑞利珠单抗^(+)白蛋白结合型紫杉醇的治疗方案;观察组在对照组方案基础上加用槐耳颗粒。治疗完成后比较两组患者的临床疗效、卡氏功能状态(Karnofsky Performance Status,KPS)评分变化情况、肿瘤标志物水平、T淋巴细胞亚群水平、预后情况以及不良反应发生情况。结果治疗后,观察组患者的疾病控制率高于对照组(73.53%vs 48.48%);卡氏评分提高率高于对照组(52.94%vs 15.15%);观察组的CD4^(+)T淋巴细胞比例及CD4^(+)/CD8^(+)均高于对照组,CD8^(+)T淋巴细胞比例低于对照组;观察组的中位PFS长于对照组[13.41个月(95%CI:11.62,15.19)vs 9.53个月(95%CI:7.76,11.30)];观察组的中位OS长于对照组[16.38个月(95%CI:14.51,18.25)和12.02个月(95%CI:10.52,13.51)];观察组的血小板减少和免疫性肺炎的发生率均低于对照组。以上差异均具有统计学意义(P<0.05)。结论槐耳颗粒联合免疫治疗用于晚期三阴性乳腺癌的解救治疗具有较好的临床疗效,且改善了患者生活质量,改善了患者预后,安全性较好。Objective To explore the clinical benefit and safety of Huaier Granules combined with immunotherapy for rescue treatment of advanced triple-negative breast cancer(TNBC).Methods A retrospective analysis was conducted on 67 advanced TNBC patients with positive PD-L1 expression treated at Cangzhou Central Hospital from November 2019 to December 2021.Patients were divided into the control group(n=33)and the observation group(n=34)based on the treatment regimens received.The control group received the treatment regimen of camrelizumab and albumin-bound paclitaxel,while the observation group additionally received Huaier Granules.Clinical efficacy,changes of Karnofsky performance status(KPS)score,levels of tumor biomarker,levels of T lymphocyte subset,prognosis,and adverse reactions were compared after treatment between the two groups.Results After treatment,the observation group exhibited higher disease control rate compared with the control group(73.53%vs 48.48%),and KPS score enhancing rate also improved(52.94%vs 15.15%).The proportions of CD4^(+)T lymphocytes and CD4^(+)/CD8^(+)in the observation group were higher than those in the control group,and the proportion of CD8^(+)T lymphocytes was lower than that in the control group.Median progression-free survival(PFS)of the observation group was longer than the control group[13.41 months(95%CI:11.62,15.19)vs 9.53 months(95%CI:7.76,11.30)],and median overall survival(OS)of the observation group was also longer than the control group[16.38 months(95%CI:14.51,18.25)vs 12.02 months(95%CI:10.52,13.51)].The incidences of thrombocytopenia and immune-related pneumonia in the observation group were lower than the control group.The above differences were statistically significant(P<0.05).Conclusion Huaier Granules combined with immunotherapy for rescue treatment of advanced TNBC shows great clinical efficacy,improves the quality of life and the prognosis of patients,and has good safety.

关 键 词：槐耳颗粒 免疫治疗 三阴性乳腺癌 解救治疗 预后 

分 类 号：R737.9[医药卫生—肿瘤] R273[医药卫生—临床医学]