三维适形放疗联合吡咯替尼对乳腺癌脑转移患者的疗效与安全性  

Efficacy and safety of three-dimensional conformal radiotherapy combined with pyrrotinib for breast cancer with brain metastases

作　　者：王丹丹[1] 亢春彦 陈建中[1] 宋宁宁[1] WANG Dandan;KANG Chunyan;CHEN Jianzhong;SONG Ningning(The Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450003,China;Henan Medical College,Xinzheng 451191,China)

机构地区：[1]郑州大学第二附属医院,河南郑州450003 [2]河南医学高等专科学校病理学教研室,河南新郑451191

出　　处：《中国实用神经疾病杂志》2024年第11期1395-1399,共5页Chinese Journal of Practical Nervous Diseases

基　　金：河南省医学科技攻关计划项目(编号:LHGJ20240293)。

摘　　要：目的探讨三维适形放疗(3D-CRT)与吡咯替尼联用对乳腺癌脑转移患者的治疗效果与安全性。方法回顾性选取2019-03—2024-03于郑州大学第二附属医院就诊的60例乳腺癌脑转移患者,按其是否服用吡咯替尼分为对照组和观察组,对比2组患者的治疗效果、生存期、干预前后的血清同型半胱氨酸(Hcy)和ICAM-1水平、Karnofsky评分(KPS)和不良反应发生情况。结果观察组疗效优于对照组(66.66%比40.00%),且生存期更长(PFS:7.98±1.83比5.11±1.51;MS:11.55±1.59比8.17±1.84;OS:14.52±2.19比11.64±3.29;P<0.05)。观察组患者KSP评分改善更明显(80.00%比53.33%,P<0.05)。观察组Hcy(654.97±175.64比835.64±216.45)和ICAM-1(11.64±7.29比17.64±8.15)水平低于对照组(P<0.05)。2组不良反应对比无统计学差异(P>0.05)。结论3D-CRT结合吡咯替尼可提高乳腺癌脑转移患者的疗效和生活自理能力,延长生存期,且不会增加额外的治疗负担,安全性较高。Objective To investigate the efficacy and safety of three-dimensional conformal radiotherapy(D-CRT)combined with pyrrotinib in the treatment of breast cancer patients with brain metastases.Methods A total of 60 patients with brain metastasized breast cancer who were admitted to the Second Affiliated Hospital of Zhengzhou University from March 2019 to March 2024 were retrospectively selected and divided into the control group and the observation group according to the principle of taking pyrrotinib or not.The treatment effect,survival time,serum homocysteine(Hcy)and ICAM-1 levels,Karnofsky score(KPS)and the occurrence of adverse reactions were compared between the two groups.Results In the observation group,the treatment effect was better(66.66%vs 40.00%),and the survival time was longer(PFS:7.98±1.83 vs 5.11±1.51;MS:11.55±1.59 vs 8.17±1.84;OS:14.52±2.19 vs 11.64±3.29;P<0.05).The KSP score of observation group was significantly improved(80.00%vs 53.33%,P<0.05).The levels of serum indexes(Hcy:654.97±175.64 vs 835.64±216.45;ICAM-1:11.64±7.29 vs 17.64±8.15)in the observation group were lower(P<0.05).There was no significant difference in adverse reactions between the two groups(P>0.05).Conclusion 3D-CRT combined with pyrrotinib can improve the efficacy and self-care ability of breast cancer patients with brain metastases,prolong survival,and does not increase the additional treatment burden,and the safety is reliable.

关 键 词：脑转移瘤 乳腺癌 三维适形放疗 吡咯替尼 安全性 

分 类 号：R739.41[医药卫生—肿瘤]