目的 分析三阴性乳腺癌改良根治术后应用白蛋白结合型紫杉醇化疗的效果及安全性.方法 选择2017年3月～2022年2月医院收治的98例三阴性乳腺癌改良根治术后患者,以随机数字表法分为对照组(n=49)、研究组(n=49).对照组术后接受表柔比星+环磷酰胺+溶剂型紫杉醇方案化疗,研究组术后接受表柔比星+环磷酰胺+白蛋白结合型紫杉醇方案化疗.21 d为1个周期,2组均化疗3个周期.比较2组卡氏功能状态(Kamofsky performance status,KPS)评分、生活质量、肿瘤标志物水平、不良反应.随访5年,比较2组生存情况.结果 化疗后,2组KPS评分、生活质量健康调查简表(the MOS item short from health survey,SF-36)评分均升高(P＜0.05),且研究组更高(P＜0.05).化疗后,2 组血清糖类抗原 153(carbohydrate antigen 153,CA153)、癌胚抗原(carcinoembryonic antigen,CEA)水平均降低(P＜0.05),且研究组更低(P＜0.05).2组Ⅰ～Ⅳ级胃肠道反应、血小板减少总发生率比较差异无统计学意义(P＞0.05),研究组Ⅰ～Ⅳ级白细胞减少、神经毒性总发生率低于对照组(P＜0.05).随访5年,对照组失访3例、研究组失访4例,研究组和对照组中位无进展生存期(progression-free surviv-al,PFS)分别为 52.74 个月(95％CI:43.85～59.27)和 36.25 个月(95％CI:15.23～50.30),研究组 PFS曲线优于对照组(P＜0.05).研究组无死亡,对照组死亡1例,2组总生存期(overall survival,OS)曲线比较差异无统计学意义(P＞0.05).结论 三阴性乳腺癌改良根治术后应用白蛋白结合型紫杉醇化疗可降低肿瘤标志物水平,改善生活质量,长期预后良好,且安全可靠.
Long-term prognosis and safety analysis of albumin-bound paclitaxel chemo-therapy after modified radical surgery for triple negative breast cancer
Objective To analyze the efficacy and safety of albumin-bound paclitaxel chemo-therapy after modified radical surgery for triple negative breast cancer.Methods A total of 98 patients with triple negative breast cancer treated in hospital from March 2017 to February 2022 after modified radical surgery were divided into control group(n=49)and study group(n=49)by random number table method.The control group received epirubicin+cyclophospha-mide+solvent-based paclitaxel chemotherapy after surgery,and the study group received epiru-bicin+cyclophosphamide+albumin-binding paclitaxel chemotherapy after surgery.Twenty-one days was 1 cycle,and both groups underwent 3 cycles of chemotherapy.Karnofsky performance status(KPS)scores,quality of life,tumor marker levels and adverse reactions were compared between the two groups.The survival of the two groups was compared after 5 years of follow-up.Results After chemotherapy,KPS score and the MOS item short from health survey(SF-36)score were increased in 2 groups(P＜0.05),and higher in study group(P＜0.05).Af-ter chemotherapy,the serum levels of carbohydrate antigen 153(CA1 53)and carcinoembryonic antigen(CEA)in 2 groups were decreased(P＜0.05),and those in the study group were lower(P＜0.05).There was no significant difference in the total incidence of gastrointestinal reactions and thrombocytopenia in grade Ⅰ to Ⅳ between the two groups(P＞0.05).The to-tal incidence of leukopenia and neurotoxicity in the study group was lower than that in the con-trol group(P＜0.05).After 5 years of follow-up,3 cases were lost to follow-up in the control group and 4 cases in the study group.The median progression-free survival(PFS)in the study group and the control group were 52.74 months(95％CI:43.85～59.27)and 36.25 months(95％CI:15.23～50.30),respectively.The PFS curve in the study group was better than that in the control group(P＜0.05).There was no death in the study group and 1 death in the control group.There was no significant difference in overall survival(OS)curve between the two groups(P＞0.05).Conclusion The use of albumin-binding paclitaxel chemotherapy af-ter modified radical surgery for triple negative breast cancer can reduce the level of tumor mark-ers,improve the quality of life,and have a good long-term prognosis,and is safe and reliable.
modified radical triple negative breast canceralbumin-bound paclitaxelchemo-therapysecuritylong-term prognosis
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