白蛋白结合型紫杉醇联合表柔比星及环磷酰胺在乳腺癌新辅助化疗中的效果及安全性

来源 :肿瘤研究与临床 | 被引量 : 0次 | 上传用户:Tianxudong
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目的:探讨白蛋白结合型紫杉醇联合表柔比星和环磷酰胺在乳腺癌新辅助化疗中的有效性和安全性。方法:回顾性分析陕西省肿瘤医院2018年8月至2019年11月行新辅助化疗及手术治疗的48例乳腺癌患者的临床病理资料。主要观察指标为病理完全缓解(pCR)率、客观缓解率(ORR)及临床获益率(CBR)。次要观察指标为化疗不良反应。结果:所有患者既定化疗周期未完成率为10.4%(5/48)。pCR率为31.2%(15/48),ORR为87.5%(42/48),CBR为95.8%(46/48)。pCR率在患者年龄、临床分期、组织学分级、cN分期及人表皮生长因子受体2(HER2)状态分组中差异均无统计学意义(均n P>0.05),在Ki-67高表达组(Ki-67阳性指数≥30%)中更高[46.7%(14/30)比16.7%(3/18),n χ2=4.427,n P=0.035]。常见的化疗不良反应为白细胞减少(93.8%,45/48)、中性粒细胞减少(93.8%,45/48)、肌肉关节疼痛(27.1%,13/48)、乏力(22.9%,11/48)、周围神经病变(18.8%,9/48)和恶心呕吐(18.8%,9/48),主要为1~2级化疗不良反应。总体3~4级化疗不良反应发生率为18.8%(9/48)。n 结论:白蛋白结合型紫杉醇联合表柔比星和环磷酰胺在乳腺癌新辅助化疗中可以取得较高的pCR率,且耐受性好。“,”Objective:To investigate the efficacy and safety of albumin-bound paclitaxel combined with epirubicin and cyclophosphamide in neoadjuvant chemotherapy for breast cancer.Methods:Clinicopathological data of 48 breast cancer patients who received neoadjuvant chemotherapy and surgery from August 2018 to November 2019 in Shaanxi Provincial Cancer Hospital were retrospectively analyzed. The primary endpoints were pathological complete remission (pCR) rate, objective response rate (ORR) and clinical benefit rate (CBR). The secondary endpoint was the adverse reactions of chemotherapy.Results:The incompletion rate of the protocol-specified courses in all patients was 10.4% (5/48). The pCR rate was 31.2% (15/48), the ORR was 87.5% (42/48), and the CBR was 95.8% (46/48). No statistic difference of pCR rate was obtained in subgroups of patients' age, clinical stage, histological grade, cN stage, and human epidermal growth factor receptor 2 (HER2) status (alln P > 0.05), but it was higher in the Ki-67 high-expression group (Ki-67 positive index ≥30%) [46.7% (14/30) vs. 16.7% (3/18), n χ2 = 4.427, n P = 0.035]. Common adverse reactions which almost were grade 1-2 included leucopenia (93.8%, 45/48), neutropenia (93.8%, 45/48), arthralgia (27.1%, 13/48), fatigue (22.9%, 11/48), peripheral neuropathy (18.8%, 9/48), and nausea and vomiting (18.8%, 9/48). The overall incidence rate of grade 3-4 adverse reactions was 18.8% (9/48).n Conclusion:The albumin-bound paclitaxel combined with epirubicin and cyclophosphamide can achieve high pCR rate in neoadjuvant chemotherapy for breast cancer, and the regimen is well tolerated.
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