吉西他滨联合顺铂化学治疗方案治疗蒽环和紫杉类药物治疗后复发三阴性乳腺癌疗效观察  

Efficacy of gemcitabine combined with cisplatin chemotherapy in the treatment of recurrent triple negative breast cancer after anthracycline and taxanes treatment

作　　者：李国明 李建红 吕建男 杨娜 王久洁 LI Guoming;LI Jianhong;LYU Jiannan;YANG Na;WANG Jiujie(Department of Breast Surgery,Hebei Petro China Central Hospital,Langfang 065000,Hebei Province,China)

机构地区：[1]河北中石油中心医院乳腺外科,河北廊坊065000

出　　处：《新乡医学院学报》2024年第12期1144-1148,共5页Journal of Xinxiang Medical University

基　　金：河北省廊坊市科学技术研究与发展计划项目(编号:2021013042)。

摘　　要：目的探讨吉西他滨联合顺铂化学治疗方案治疗蒽环和紫杉类药物治疗后复发三阴性乳腺癌(TNBC)患者的临床疗效及对肿瘤标志物水平的影响。方法选择2020年1月至2021年1月河北中石油中心医院乳腺外科收治的61例蒽环和紫杉类药物治疗后复发TNBC患者为研究对象,根据化学治疗方案不同将患者分为观察组(n=31)和对照组(n=30)。观察组患者给予吉西他滨联合顺铂化学治疗方案,对照组患者给予长春瑞滨联合顺铂化学治疗方案,2组均持续治疗4个周期(21 d为1个周期)。比较2组患者治疗后的临床疗效。分别于治疗前及治疗4个周期后抽取2组患者空腹外周静脉血5 mL,采用酶联免疫吸附试验检测血清癌胚抗原(CEA)、糖类抗原125(CA125)及胸苷激酶1(TK1)水平。记录2组患者恶心呕吐、腹泻、白细胞减少、血小板减少、红细胞减少、肝功能损害、肾功能损害等不良反应,并比较不良反应发生率。比较2组患者3 a总体生存率。结果对照组患者客观缓解率(ORR)、疾病控制率(DCR)分别为26.67%(8/30)、60.00%(18/30);观察组患者ORR、DCR分别为51.61%(16/31)、83.87%(26/31);观察组患者ORR、DCR显著高于对照组(χ^(2)=3.976、4.322,P<0.05)。治疗前2组患者血清CEA、CA125及TK1水平比较差异无统计学意义(P>0.05)。2组患者治疗后血清CEA、CA125及TK1水平显著低于治疗前(P<0.05);治疗后,观察组患者血清CEA、CA125及TK1水平显著低于对照组(P<0.05)。观察组患者血小板减少、肾功能损害发生率显著低于对照组(χ^(2)=4.546、5.088,P<0.05);2组患者其他不良反应发生率比较差异无统计学意义(P>0.05)。结论吉西他滨联合顺铂化学治疗方案治疗蒽环和紫杉类药物治疗后复发TNBC患者的疗效较好,可有效调节肿瘤标志物水平,降低不良反应发生率,提高患者生存率。Objective To explore the clinical efficacy of gemcitabine combined with cisplatin chemotherapy in the treatment of patients with recurrent triple negative breast cancer(TNBC)after anthracycline and taxanes treatment and its influence on tumor markers.Methods A total of 61 patients with recurrent TNBC after anthracycline and taxanes treatment,who were admitted to the Department of Breast Surgery,Hebei Petro China Central Hospital from January 2020 to January 2021,were selected as the research subjects.The patients were divided into observation group(n=31)and control group(n=30)according to different chemotherapy schemes.The patients in the observation group were given gemcitabine combined with cisplatin chemotherapy,while the patients in the control group were given vinorelbine combined with cisplatin chemotherapy.Patients in both groups were treated for 4 continuous cycles(21 days each cycle).The clinical efficacy of patients between the two groups after treatment was compared.Before treatment and after 4 cycles of treatment,5 mL of fasting peripheral venous blood was taken from patients in the two groups,and the serum levels of carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125)and thymidine kinase 1(TK1)were detected by using the enzyme-linked immunosorbent assay.The adverse reactions of patients in the two groups were recorded,including nausea and vomiting,diarrhea,leukopenia,thrombocytopenia,erythropenia,liver function damage and renal function damage,and the incidence of adverse reactions was compared.The overall 3-year survival rate of patients in the two groups was compared.Results The objective remission rate(ORR)and disease control rate(DCR)of patients in the control group were 26.67%(8/30)and 60.00%(18/30),respectively.The ORR and DCR of patients in the observation group were 51.61%(16/31)and 83.87%(26/31),respectively.The ORR and DCR of patients in the observation group were significantly higher than those in the control group(χ^(2)=3.976,4.322;P<0.05).There was no statistically significant

关 键 词：吉西他滨 顺铂 复发三阴性乳腺癌 临床疗效 肿瘤标志物 生存率 

分 类 号：R737.9[医药卫生—肿瘤]