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目的 :分析Her-2状态对洛铂联合其他药物治疗转移性乳腺癌的疗效影响。方法 :回顾性分析2010年1月—2014年12月113例Her-2检测结果明确且使用含洛铂方案治疗的转移性乳腺癌病例,评价其疗效及不良反应。结果:共收集113例,其中111例可评价疗效。Her-2阳性组35例(31.5%),1例完全缓解(CR),15例部分缓解(PR),15例疾病稳定(SD)[客观有效率(ORR):45.7%,疾病控制率(DCR)88.6%]。Her-2阴性组76例,1例CR,16例PR,37例SD(RR:22.4%,DCR 71.1%),两组间RR(P=0.012)及DCR(P=0.043)比较均具有显著统计学差异。两组中位疾病进展时间(TTP)亦存在显著差异。主要不良反应为骨髓抑制,3/4级中性粒细胞下降24例(21.2%),17例(15.0%)患者出现3/4级血小板下降,其他不良反应包括消化道反应、轻度肝损害、疲乏、周围神经病变、口腔炎及皮疹等,多为1/2级轻度反应,经对症处理后均能缓解。结论:晚期乳腺癌Her-2状态影响洛铂为基础的治疗方案疗效,Her-2阳性者对治疗更敏感,中位TTP更长。
OBJECTIVE: To analyze the effect of Her-2 status on the efficacy of lobaplatin and other drugs in the treatment of metastatic breast cancer. Methods: A retrospective analysis of 113 cases of Her-2 test results from January 2010 to December 2014 in which metastatic breast cancer was treated with lobaplatin-containing regimen was performed to evaluate the efficacy and adverse reactions. Results: A total of 113 cases were collected, of which 111 cases could be evaluated. Fifteen patients (31.5%) in Her-2 positive group, one patient with complete remission (CR), 15 patients with partial remission (PR) and 15 patients with stable disease (SD) [objective response rate (ORR): 45.7% DCR) 88.6%]. There were 76 cases in the Her-2 negative group, 1 case of CR, 16 cases of PR and 37 cases of SD (RR: 22.4%, DCR 71.1%). There was significant difference between the two groups in RR (P = 0.012) and DCR Statistical differences. There was also a significant difference in the median progression time (TTP) between the two groups. The main adverse reactions were myelosuppression, 24 (21.2%) patients with grade 3/4 neutropenia and 3/4 thrombocytopenia in 17 (15.0%) patients. Other adverse reactions included digestive tract reactions, mild liver damage , Fatigue, peripheral neuropathy, stomatitis and rash, mostly mild reaction level 1/2, after symptomatic treatment can be alleviated. CONCLUSIONS: Her-2 status in advanced breast cancer affects the efficacy of the lobaplatin-based regimen, which is more sensitive to treatment and longer for the median TTP.