氟维司群联合达尔西利治疗激素受体阳性晚期乳腺癌患者的临床研究  

A Clinical Study of Fulvestrant Combined with Dalpiciclib in Patients with Hormone Receptor-Positive Advanced Breast Cancer

作　　者：何建鑫 王文胜[1] 刘玉桐 刘晓亚 马志强[1] HE Jian-xin;WANG Wen-sheng;LIU Yu-tong;LIU Xiao-ya;MA Zhi-qiang(The First Affiliated Hospital of Henan University,Kaifeng 475000,China)

机构地区：[1]河南大学第一附属医院,开封475000

出　　处：《中国合理用药探索》2025年第1期33-39,共7页Chinese Journal of Rational Drug Use

基　　金：国家卫生健康委医院管理研究所“乳腺癌单病种诊疗能力提升项目科研课题”项目(RXDBZ-2022-08)。

摘　　要：目的:探讨氟维司群联合达尔西利治疗激素受体(HR)阳性晚期乳腺癌患者的临床疗效。方法:选取2019年1月~2022年12月河南大学第一附属医院乳腺外科收治的88例HR阳性晚期乳腺癌患者作为研究对象,采用随机数字表法分为对照组(n=48)和观察组(n=40)。对照组给予氟维司群治疗,观察组在对照组基础上给予达尔西利治疗。比较两组患者临床疗效、免疫功能、生活质量、生存情况及不良反应发生情况。结果:观察组患者治疗总有效率(65.00%)高于对照组(41.67%,P<0.05)。治疗后,观察组患者CD19^(+)和CD8^(+)均降低,且低于对照组(P<0.05);CD3^(+)和CD4^(+)/CD8^(+)均升高,且高于对照组(P<0.05);两组患者Karnofsky评分升高,且观察组高于对照组(P<0.05)。随访12~36个月,中位随访时间28个月。至随访结束,观察组无进展生存期(PFS)(15个月)长于对照组(9个月,χ^(2)=18.310,P<0.001);观察组总生存期(OS)(24个月)长于对照组(18个月,χ^(2)=4.157,P=0.042)。观察组患者血红蛋白降低、白细胞降低的发生率高于对照组(P<0.05)。结论:氟维司群联合达尔西利能提高HR阳性晚期乳腺癌患者的临床疗效,改善免疫功能,延长患者生存时间,但同时也需要注意,时刻监测不良反应的发生并采取相应的治疗措施,以保障患者用药安全。Objective:To investigate the clinical efficacy of fulvestrant combined with dalpiciclib in patients with hormone receptor(HR)-positive advanced breast cancer.Methods:A total of 88 patients with HR-positive advanced breast cancer treated in the Department of Breast Surgery,The First Affiliated Hospital of Henan University from January 2019 to December 2022,were selected and assigned to the control group(n=48)and observation group(n=40)by random number table.The control group was treated with Fulvestrant,and the observation group was treated with Dalpiciclib in addition to the treatment given in the control group.The clinical efficacy,immune function,quality of life,survival and adverse reactions were compared between the two groups.Results:After treatment,the total response rate in the observation group(65.00%)was higher than that in the control group(41.67%,P<0.05).The levels of CD19^(+)and CD8^(+)in the observation group were decreased,and lower than those in the control group(P<0.05).The levels of CD3^(+),CD4^(+)/CD8^(+)in the observation group were increased and higher than those in the control group(P<0.05).Karnofsky scores were increased in both groups,with the observation group showing higher scores than the control group(P<0.05).The follow-up period ranged from 12 to 36 months,with a median of 28 months.By the end of follow-up,the progression-free survival(PFS)in the observation group(15 months)was longer than that in the control group(9 months,χ^(2)=18.310,P<0.001).Overall survival(OS)in the observation group(24 months)was longer than that in the control group(18months,χ^(2)=4.157,P=0.042).The incidence of decreased hemoglobin and decreased white blood cell in the observation group was higher than that in the control group(P<0.05).Conclusion:Fulvestrant combined with Dalpiciclib can improve the clinical efficacy,enhance immune function and prolong survival in patients with HR-positive advanced breast cancer.However,it is also important to continuously monitor the occurrence of adverse reactions and take

关 键 词：氟维司群 达尔西利 激素受体阳性 晚期乳腺癌 临床疗效 免疫功能 

分 类 号：R737.9[医药卫生—肿瘤]