白蛋白结合型紫杉醇与多西紫杉醇在人表皮生长因子受体-2阳性乳腺癌患者新辅助化疗中的疗效对比研究  

Efficacy of albumin-bound paclitaxel and docetaxel in neoadjuvant chemotherapy of patients with HER2-positive breast cancer

作　　者：周永安 阮勇[3] ZHOU Yongan;RUAN Yong(Jinzhou Medical University,Jinzhou 121001,China)

机构地区：[1]锦州医科大学,辽宁锦州121001 [2]黄石市中心医院湖北理工学院附属医院乳腺甲状腺外Ⅱ科,湖北黄石435000 [3]鄂东医养集团黄石市第二医院胃肠外科,湖北黄石435000

出　　处：《陕西医学杂志》2024年第9期1236-1239,1244,共5页Shaanxi Medical Journal

基　　金：湖北省医学科研课题(HBJG-200059);湖北省黄石市中心医院科研项目(ZX2023Q04)。

摘　　要：目的:分析曲妥珠单抗+帕妥珠单抗分别联合不同类型紫杉醇应用于人表皮生长因子受体-2(HER2)阳性乳腺癌的疗效。方法:纳入90例拟行新辅助化疗的HER2阳性乳腺癌患者,根据曲妥珠单抗+帕妥珠单抗分别联合不同类型紫杉醇,将患者分为两组,44例采用多西紫杉醇方案化疗分为对照组,46例采用白蛋白结合型紫杉醇方案化疗分为观察组。以21 d为1个周期,治疗6个周期后,比较两组近期疗效、化疗前后Ki-67阳性率、基质金属蛋白酶-9(MMP-9)相对表达量、组织多肽特异性抗原(TPS)水平、生存情况、不良反应。结果:两组客观缓解率、疾病控制率比较差异无统计学意义(均P>0.05),两组总体病理完全缓解率比较差异有统计学意义(P<0.05)。治疗6个周期后,两组Ki-67阳性率、MMP-9相对表达量、TPS水平均降低,且观察组低于对照组(均P<0.05)。观察组中位生存期长于对照组(P<0.05)。两组不良反应比较差异无统计学意义(均P>0.05)。结论:相较于多西紫杉醇,白蛋白结合型紫杉醇可提高HER2阳性乳腺癌患者总体病理完全缓解率,降低Ki-67阳性率、MMP-9相对表达量和TPS水平,延长患者生存期。Objective:To analyze the efficacy of trastuzumab+pertuzumab combined with different types of paclitaxel in the treatment of patients with human epidermal growth factor receptor-2(HER2)-positive breast cancer.Methods:The 90 patients with HER2-positive breast cancer included in this study were scheduled to receive neoadjuvant chemotherapy.Patients were divided into two groups according to trastuzumab+pertuzumab combined with different types of paclitaxel,and 44 cases with docetaxel chemotherapy regimen were enrolled as control group,and the remaining 46 cases receiving albumin-bound paclitaxel chemotherapy regimen were included in observation group.Both groups took 21 days as one cycle of treatment.The short-term efficacy after 6 cycles of treatment,the positive rate of Ki-67,the relative expression of MMP-9 and the level of TPS before and after chemotherapy,survival status and adverse reactions were compared between groups.Results:There were no statistical differences in objective response rate and disease control rate between both groups(all P>0.05).The overall pathological complete response rate of the two groups was statistically significant(P<0.05).After 6 cycles of treatment,the positive rate of Ki-67,relative expression level of MMP-9 and TPS level in the two groups were decreased,and the above indicators were lower in observation group than those in control group(all P<0.05).The median survival time in observation group was longer compared to control group(P<0.05).The adverse reactions between the two groups were not statistically different(all P>0.05).Conclusion:Compared with docetaxel,albumin-bound paclitaxel can better improve the total pathological complete response rate of patients with HER2-positive breast cancer,reduce the positive rate of Ki-67,relative expression of MMP-9 and level of TPS,and prolong the survival time of patients.

关 键 词：乳腺癌 白蛋白结合型紫杉醇 曲妥珠单抗 帕妥珠单抗 多西紫杉醇 人表皮生长因子受体-2 新辅助化疗 

分 类 号：R737.9[医药卫生—肿瘤]