中华肿瘤杂志
中華腫瘤雜誌
중화종류잡지
CHINESE JOURNAL OF ONCOLOGY
2010年
11期
864-867
,共4页
王研%李俊杰%狄根红%陆劲松%吴炅%柳光宇%胡夕春%王中华%杨文涛%邵志敏
王研%李俊傑%狄根紅%陸勁鬆%吳炅%柳光宇%鬍夕春%王中華%楊文濤%邵誌敏
왕연%리준걸%적근홍%륙경송%오경%류광우%호석춘%왕중화%양문도%소지민
乳腺肿瘤%药物疗法%曲妥珠单抗%人表皮生长因子受体2
乳腺腫瘤%藥物療法%麯妥珠單抗%人錶皮生長因子受體2
유선종류%약물요법%곡타주단항%인표피생장인자수체2
Breast neoplasm%Drug therapy%Trastuzumab%Her-2
目的 总结曲妥珠单抗在人表皮生长因子受体2(Her-2)阳性乳腺癌患者新辅助、辅助和复发转移治疗中的临床应用经验,评价其与化疗联用的疗效.方法 对2004年1月至2008年12月门诊应用曲妥珠单抗治疗的141乳腺癌患者进行回顾性分析.随访时间为3～319个月.分析患者的无病生存时间(DFS),比较患者辅助、复发转移一线及二线使用曲妥珠单抗治疗的总生存时间(OS)、治疗失败时间(TTF)和临床有效率的差异.结果 与曲妥珠单抗治疗联用的新辅助化疗中,紫杉醇联合卡铂方案占66.7%;辅助治疗中,蒽环类和蒽环类序贯紫杉类方案占53.9%.复发转移的患者治疗后中位DFS为17个月.复发转移的患者经一线曲妥珠单抗联合化疗治疗后,临床总有效 率为84.5%,中位TTF为24个月;二线治疗有效率为44.4%,中位TTF为5个月.两者比较,差异有统计学意义(P=0.002).结论 紫杉醇和卡铂化疗联合曲妥珠单抗,值得在新辅助治疗中推广,紫杉类和蒽环类联合或序贯靶向治疗仍是辅助治疗的标准方案.转移性乳腺癌一线应用曲妥珠单抗联合化疗比二线治疗的临床有效率更高,在继续应用曲妥珠单抗的基础上改用化疗方案,可提高治疗有效率,减少治疗失败的概率.
目的 總結麯妥珠單抗在人錶皮生長因子受體2(Her-2)暘性乳腺癌患者新輔助、輔助和複髮轉移治療中的臨床應用經驗,評價其與化療聯用的療效.方法 對2004年1月至2008年12月門診應用麯妥珠單抗治療的141乳腺癌患者進行迴顧性分析.隨訪時間為3～319箇月.分析患者的無病生存時間(DFS),比較患者輔助、複髮轉移一線及二線使用麯妥珠單抗治療的總生存時間(OS)、治療失敗時間(TTF)和臨床有效率的差異.結果 與麯妥珠單抗治療聯用的新輔助化療中,紫杉醇聯閤卡鉑方案佔66.7%;輔助治療中,蒽環類和蒽環類序貫紫杉類方案佔53.9%.複髮轉移的患者治療後中位DFS為17箇月.複髮轉移的患者經一線麯妥珠單抗聯閤化療治療後,臨床總有效 率為84.5%,中位TTF為24箇月;二線治療有效率為44.4%,中位TTF為5箇月.兩者比較,差異有統計學意義(P=0.002).結論 紫杉醇和卡鉑化療聯閤麯妥珠單抗,值得在新輔助治療中推廣,紫杉類和蒽環類聯閤或序貫靶嚮治療仍是輔助治療的標準方案.轉移性乳腺癌一線應用麯妥珠單抗聯閤化療比二線治療的臨床有效率更高,在繼續應用麯妥珠單抗的基礎上改用化療方案,可提高治療有效率,減少治療失敗的概率.
목적 총결곡타주단항재인표피생장인자수체2(Her-2)양성유선암환자신보조、보조화복발전이치료중적림상응용경험,평개기여화료련용적료효.방법 대2004년1월지2008년12월문진응용곡타주단항치료적141유선암환자진행회고성분석.수방시간위3～319개월.분석환자적무병생존시간(DFS),비교환자보조、복발전이일선급이선사용곡타주단항치료적총생존시간(OS)、치료실패시간(TTF)화림상유효솔적차이.결과 여곡타주단항치료련용적신보조화료중,자삼순연합잡박방안점66.7%;보조치료중,은배류화은배류서관자삼류방안점53.9%.복발전이적환자치료후중위DFS위17개월.복발전이적환자경일선곡타주단항연합화료치료후,림상총유효 솔위84.5%,중위TTF위24개월;이선치료유효솔위44.4%,중위TTF위5개월.량자비교,차이유통계학의의(P=0.002).결론 자삼순화잡박화료연합곡타주단항,치득재신보조치료중추엄,자삼류화은배류연합혹서관파향치료잉시보조치료적표준방안.전이성유선암일선응용곡타주단항연합화료비이선치료적림상유효솔경고,재계속응용곡타주단항적기출상개용화료방안,가제고치료유효솔,감소치료실패적개솔.
Objective To summarize the clinical experience of trastuzumab treatment in neoadjuvant, adjuvant, metastatic setting of Chinese patients with Her-2 positive breast cancer and evaluate the efficacy of trastuzumab in combination with chemotherapy. Methods From January 2004 to December 2008, 141 outpatients with breast cancer treated with trastuzumab were investigated retrospectively. The follow-up time ranged from 3 to 319 months. The disease free survival time (DFS) of metastatic setting was calculated. The overall survival time (OS), time to treatment failure (TTF) and clinical response rate (CRR, including complete reponse, partial response and stable disease) of adjuvant, first-line, second-line therapy were analyzed statistically. Results In the neoadjuvant regimen, paclitaxel plus carboplatin in combination with trastuzumab accounted for 66.7%, which achieved pathological complete response in 10 of 16 patients. In the adjuvant regimen, anthracycline or anthracycline followed by taxane accounted for 53.9%. The median DFS of 57 cases with metastatic diseases was 17 months. The CRR of first-line trastuzumab use in metastatic setting was 84.5%, compared with 44.4% of second-line use. The median TTF of first-line treatment was 24 months compared with 5 months of second-line treatment. Statistically significant differences were observed. Conclusion The regimen of paclitaxel plus carboplatin in combination with trastuzumab deserves wide clinical use. In metastatic setting, first-line treatment of trastuzumab plus chemotherapy can achieve a higher response rate than second-line treatment. Continued trastuzumab therapy combined with different chemotherapy treatment after disease progression may obtain additive clinical advantage.
