改良TAC方案在HER-2阴性乳腺癌新辅助化疗中的应用效果分析  

Analysis of the practical effect of modified TAC regimen in the neoadjuvant chemotherapy of HER-2 negative breast cancer

作　　者：彭显更 焦庆丽 PENG Xian-geng;JIAO Qing-li(Department of Breast and Thyroid Surgery,Liaocheng People's Hospital,Liaocheng 252000,China)

机构地区：[1]聊城市人民医院乳腺甲状腺外科,252000

出　　处：《中国实用医药》2024年第13期16-20,共5页China Practical Medicine

摘　　要：目的分析改良TAC方案(盐酸多柔比星脂质体联合白蛋白结合型紫杉醇及环磷酰胺)在人表皮生长因子受体2(HER-2)阴性乳腺癌新辅助化疗中的应用效果。方法80例接受新辅助化疗的HER-2阴性乳腺癌患者,采用随机数字表法分为观察组和对照组,每组40例。观察组采用改良TAC方案,对照组采用表柔比星、多西他赛、环磷酰胺化疗方案。比较两组的临床疗效、化疗不良反应发生情况以及治疗前后的生活质量评分、心肌酶谱相关指标[肌酸激酶同工酶(CK-MB)、肌酸激酶(CK)、肌钙蛋白I(cTnI)]、左室射血分数(LVEF)和血清肿瘤标志物[糖类抗原(CA)15-3、CA19-9及癌胚抗原(CEA)]水平。结果观察组患者临床总有效率82.50%和完全缓解(CR)率27.50%明显高于对照组的60.00%、10.00%,差异有统计学意义(P<0.05)。治疗后,观察组患者的CA15-3、CA19-9及CEA水平分别为(7.83±1.37)U/ml、(10.20±1.36)U/ml、(1.18±0.27)ng/ml,均明显低于对照组的(15.38±2.69)U/ml、(16.28±1.04)U/ml、(2.65±0.95)ng/ml,差异有统计学意义(P<0.05)。治疗后,观察组患者的LVEF(62.43±4.37)%高于对照组的(57.28±5.46)%,CK-MB(20.58±2.36)U/L、cTnI(33.92±6.37)μg/ml、CK(122.07±20.45)U/L均低于对照组的(32.18±3.03)U/L、(42.78±8.25)μg/ml、(137.57±27.69)U/L,差异有统计学意义(P<0.05)。观察组患者心脏毒性、胃肠道反应发生率分别为7.50%、25.00%,低于对照组的32.50%、47.50%,差异有统计学意义(P<0.05)。观察组患者化疗后社会功能、角色功能、情绪功能、躯体功能评分分别为(77.28±3.18)、(78.18±4.27)、(76.94±5.11)、(77.87±4.13)分,明显高于对照组的(64.14±2.29)、(65.35±2.96)、(65.72±2.58)、(66.03±3.29)分,差异有统计学意义(P<0.05)。结论在HER-2阴性乳腺癌新辅助化疗中应用改良TAC方案能够提高临床效果,减少传统化疗药物导致的心脏毒性等化疗不良反应的发生,显著改善患者的生活质量,值得推广应用。Objective To analyze the practical effect of modified TAC regimen(doxorubicin hydrochloride liposome combined with albumin-bound paclitaxel and cyclophosphamide)in the neoadjuvant chemotherapy of human epidermal growth factor receptor 2(HER-2)negative breast cancer.Methods 80 patients with HER-2 negative breast cancer who received neoadjuvant chemotherapy were selected and randomly divided into an observation group and a control group,with 40 cases in each group.The observation group was treated with modified TAC regimen,while the control group was treated with epirubicin,docetaxel and cyclophosphamide chemotherapy.Both groups were compared in terms of the clinical efficacy,incidence of adverse reactions to chemotherapy,quality of life,myocardial enzyme spectrum related indicators[creatine kinase isoenzyme(CK-MB),creatine kinase(CK),cardiac troponin I(cTnI)],left ventricular ejection fraction(LVEF),and serum tumor markers[carbohydrate antigen(CA)15-3,CA19-9,and carcinoembryonic antigen(CEA)]levels before and after treatment.Results The observation group had total effective rate of 82.50%and complete response(CR)rate of 27.50%,which were significantly higher than 60.00%and 10.00%in the control group,and the difference was statistically significant(P<0.05).After treatment,the levels of CA15-3,CA19-9 and CEA in the observation group were(7.83±1.37)U/ml,(10.20±1.36)U/ml and(1.18±0.27)ng/ml,which were significantly lower than(16.28±1.04)U/ml,(16.28±1.04)U/ml and(2.65±0.95)ng/ml in the control group,and the difference was statistically significant(P<0.05).After treatment,the observation group had higher LVEF of(62.43±4.37)%than(57.28±5.46)%in the control group;the observation group had CK-MB of(20.58±2.36)U/L,cTnI of(33.92±6.37)μg/ml and CK of(122.07±20.45)U/L,which were lower than(32.18±3.03)U/L,(42.78±8.25)μg/ml and(137.57±27.69)U/L in the control group;the difference was statistically significant(P<0.05).The incidence of cardiotoxicity and gastrointestinal reactions in the observation group were 7.50

关 键 词：乳腺癌 人表皮生长因子受体2阴性 盐酸多柔比星脂质体 白蛋白结合型紫杉醇 环磷酰胺 

分 类 号：R737.9[医药卫生—肿瘤]