SOX方案和GP方案对晚期三阴乳腺癌患者临床疗效及CA153、CEA水平的影响-东南大学学报医学版

SOX方案和GP方案对晚期三阴乳腺癌患者临床疗效及CA153、CEA水平的影响

单位：1. 盐城卫生职业技术学院, 江苏盐城 224005;
2. 盐城市第一人民医院, 江苏盐城 224000

分类号：R737.9

出版年·卷·期（页码）：2017·36·第五期（728-734）

摘要：

目的：探讨奥沙利铂联合替吉奥（SOX方案）和吉西他滨联合顺铂（GP方案）对晚期三阴乳腺癌患者临床疗效及糖类抗原153（CA153）、癌胚抗原（CEA）水平的影响。方法：选取2012年8月至2015年8月盐城市第一人民医院的134例晚期三阴乳腺癌患者作为研究对象，根据随机数字表法分为A组和B组，每组各67例，A组患者给予SOX方案治疗，B组患者给予GP方案治疗，对比分析两组患者近期疗效、远期疗效、不良反应以及血清CA153和CEA水平。结果：A组患者总有效率（RR）和疾病控制率（DCR）分别为35.82%和68.66%，B组患者RR和DCR分别为34.33%和65.67%，两组差异均无统计学意义（P>0.05）；A组和B组患者中位疾病进展时间分别为9.7个月和8.2个月，差异具有统计学意义（P=0.031）；A组和B组患者1年生存率分别为70.15%和64.18%，差异无统计学意义（P=0.462）；A组和B组患者中位总生存时间分别为20.1个月和19.4个月，差异无统计学意义（P=0.289）。两组患者常见不良反应相似，其中A组患者手足综合征、肝功能损伤、腹泻以及外周神经毒性发生率分别为44.78%、46.27%、40.30%和58.21%，均显著高于B组患者（分别为0、23.88%、17.91%和14.93%），差异均有统计学意义（P<0.05）；A组患者皮疹、恶心/呕吐、血小板降低和肾脏毒性发生率分别为19.40%、41.79%、41.79%和7.46%，均显著低于B组患者（分别为37.31%、70.15%、65.67%和28.36%），差异均有统计学意义（P<0.05）；治疗后，两组患者CA153、CEA水平与治疗前相比均显著降低，差异具体统计学意义（P<0.05）；且治疗后两组患者CA153、CEA水平比较，差异均无有统计学意义（P>0.05）。结论：临床晚期三阴乳腺癌患者采用SOX方案和GP方案治疗，均可取得理想疗效，且耐受性较好。

Objective:To explore the effects of Oxaliplatin plus S-1(SOX) and Gemcitabine plus Cisplatin (GP) regimens on advanced triple-negative breast cancer patients and its affection on levels of carbohydrate antigen 153(CA153) and carcinoembryonic antigen(CEA). Methods:134 patients with advanced triple-negative breast cancer treated in Yancheng City First People's Hospital from August 2012 to August 2015 were selected, and divided into group A and group B(67 cases in each group). Group A was treated with SOX regimen, and group B was treated with GP regimen. The short term effect, long term curative, adverse reactions,serum CA153 and CEA levels were compared between the two groups. Results:After treatment, the response rate and disease control rate of group A was 35.82% and 68.66%, and group B was 34.33% and 65.67%, the difference was not statistically significant(P>0.05).The median time to progression was 9.7 months in group A and 8.2 months in group B, the difference between the two groups was statistical significantly(P=0.031). The 1-year survival rates was 70.15% in group A and 64.18% in group B, the difference was not statistically significant(P=0.462). The median time to overall survival was 20.1 months in group A and 19.4 months in group B, the difference was not statistically significant(P=0.289). Adverse reactions were similar between the two groups. The incidence of hand-foot syndrome, liver function damage, diarrhea and peripheral nerve toxicity in group A were 44.78%, 46.27%, 40.30% and 58.21%, were significantly higher than those in group B(0, 23.88%, 17.91% and 14.93%), the difference between the two groups was statistically significant(P<0.05). The incidence of skin rash, nausea/vomiting, thrombocytopenia and renal toxicity in group A were 19.40%, 41.79%, 41.79% and 7.46%, were significantly lower than those in group B(37.31%, 70.15%, 65.67% and 28.36%), the difference between the two groups was statistically significant(P<0.05). After treatment,the levels of CA135 and CEA of the two groups were significantly reduced compared with before, the difference was statistically significant(P<0.05). And the levels of CA135 and CEA of two groups had no statistically significant difference after treatment(P>0.05). Conclusion:Both SOX and GP regimens are safe, effective and tolerable in reating advanced triple-negative breast cancer patients.

参考文献：

[1] 项丹,姜藻,顾晓怡.西达本胺联合顺铂对三阴乳腺癌细胞株MDA-MB-231的体外抗增殖作用及其机制的研究[J].东南大学学报:医学版,2013,32(3):283-288.
[2] MATHE A,SCOTT R J,AVERY-KIEJDA K A.MiRNAs and Other Epigenetic Changes as Biomarkers in Triple Negative Breast Cancer[J].Int J Mol Sci,2015,16(12):28347-28376.
[3] 袁业伟,孙治君.三阴性乳腺癌最新治疗及研究进展[J].重庆医学,2015,44(16):2279-2282.
[4] PALMA G,FRASCI G,CHIRICO A,et al.Triple negative breast cancer:looking for the missing link between biology and treatments[J].Oncotarget,2015,6(29):26560-26574.
[5] 杨慧,黄海欣,李桂生.吉西他滨联合卡铂或顺铂治疗晚期三阴乳腺癌的疗效观察[J].现代肿瘤医学,2014,22(5):1076-1078.
[6] 刘君,肖扬,马益慧,等.奥沙利铂联合替吉奥治疗难治性晚期乳腺癌临床观察[J].国际肿瘤学杂志,2016,43(5):330-334.
[7] 戴峰,张秀明,陈骏,等.肝细胞肝癌TAE前后血清HIF-1α、VEGF表达与疗效的相关性研究[J].东南大学学报:医学版,2016,35(4):537-540.
[8] LE D F.Is the future of personalized therapy in triple-negative breast cancer based on molecular subtype?[J].Oncotarget,2015,6(15):12890-12908.
[9] 刘莉萍,魏亚,白君,等.基底细胞样乳腺癌与三阴性乳腺癌临床病理特征[J].中华全科医学,2014,12(2):216-218.
[10] LEHMANN B D,PIETENPOL J A.Identification and use of biomarkers in treatment strategies for triple negative breast cancer subtypes[J].J Pathol,2014,232(2):142-150.
[11] RASTELLI F,BIANCANELLI S,FALZETTA A,et al.Triple-negative breast cancer:current state of the art[J].Tumori,2010,96(6):875-888.
[12] 罗海涛,邹静荷,古伟光,等.卡培他滨维持治疗对联合化疗有效的复发转移三阴乳腺癌的临床观察[J].重庆医学,2015,44(24):3357-3359.
[13] 樊英,徐兵河.BRCA1/BRCA2相关性乳腺癌的全身治疗[J].临床药物治疗杂志,2011,9(1):48-50.
[14] UHM J E,PARK Y H,YI S Y,et al.Treatment outcomes and clinicopathologic characteristics of triple-negative breast cancer patients who received platinum-containing chemotherapy[J].Int J Cancer,2009,124(6):1457-1462.
[15] BRODOWICZ T,KOSTLER W J,MÖSLINGER R,et al.Single-agent gemcitabine as second-and third-line treatment in metastatic breast cancer[J].Breast,2001,9(6):338-342.
[16] 蔡锐刚,徐兵河.吉西他滨联合顺铂方案治疗晚期乳腺癌临床研究[J].中国肿瘤,2014,23(7):612-615.
[17] 谷子.吉西他滨联合卡培他滨与顺铂治疗耐药性晚期乳腺癌的近期疗效及不良反应比较[J].实用医院临床杂志,2014,11(5):82-85.
[18] 王梦洁,孙苏平.替吉奥和卡培他滨治疗老年晚期乳腺癌临床疗效及安全性比较[J].现代仪器与医疗,2014,20(6):36-38.
[19] 曾利军,陈建魁,于农,等.血清CEA、CA153和CYFRA21-1联合检测对乳腺癌的诊断价值[J].临床误诊误治,2011,24(6):72-74.
[20] MOLINA R,FILELLA X,ALICARTE J,et al.Prospective evaluation of CEA and CA 15.3 in patients with locoregional breast cancer[J].Anticancer Res,2003,23(6):1035-1041.
[21] 苏晓玥,杨伟明,杨雪峰,等.CEA和PTEN在双侧原发性乳腺癌中的表达和分析[J].贵州医药,2015,39(9):779-781.

服务与反馈：

【文章下载】【发表评论】【查看评论】【加入收藏】

提示：您还未登录，请登录！点此登录