2020 年第 9 期 第 15 卷

鸦胆子油乳注射液联合多西他赛和吡柔比星及环磷酰胺治疗晚期乳腺癌的临床效果

Clinical effect of brucea javanica oil emulsion injection combined with docetaxel, pirarubicin and cyclophosphamide in treatment of advanced breast cancer

作者：李一黄婷杨麟瀚吴池华

英文作者：Li Yi Huang Ting Yang Linhan Wu Chihua 

单位：四川省医学科学院·四川省人民医院乳腺外科，成都610072

英文单位：Department of Breast Surgery Sichuan Academy of Medical Sciences Sichuan Provincial People′s Hospital Chengdu 610072 China

关键词：晚期乳腺癌；鸦胆子油乳注射液；多西他赛；吡柔比星；环磷酰胺

英文关键词：Advancedbreastcancer;Bruceajavanicaoilemulsioninjection;Docetaxel;Pirarubicin;Cyclophosphamide

• 摘要：

• 目的 探讨鸦胆子油乳注射液联合多西他赛、吡柔比星、环磷酰胺（TAC）方案治疗晚期乳腺癌的临床效果。方法 选取2017年1月至2018年12月四川省人民医院接收的250例晚期乳腺癌患者，根据随机数字表法将患者分为对照组和观察组，各125例。对照组患者予以TAC方案治疗，观察组在对照组基础上联合鸦胆子油乳注射液治疗。比较2组患者临床疗效、免疫功能、血清肿瘤指标，记录治疗期间不良反应情况。结果 观察组治疗4个周期后总有效率明显高于对照组［82.4%(103/125)比70.4%(88/125)］，差异有统计学意义（P＝0.025）。2组治疗后CD+8水平均升高，但观察组低于对照组［（29±4）%比（35±4）%］，CD+3、CD+4、CD+4/CD+8比值均下降，但观察组高于对照组［（52±9）%比（44±7）%、（32±5）%比（28±4）%、（1.10±0.24）比（0.80±0.17）］,差异均有统计学意义（均P＜0.05）。2组患者治疗后血清糖类抗原15-3、癌胚抗原、血管内皮生长因子水平均降低，且观察组低于对照组，差异均有统计学意义（均P＜0.05）。2组治疗期间不良反应发生率差异无统计学意义（P＝0.562）。结论 鸦胆子油乳注射液联合TAC方案治疗晚期乳腺癌疗效确切，可减轻机体免疫抑制，阻止肿瘤进展，且不增加不良反应发生率。

• Objective To investigate the clinical effect of brucea javanica oil emulsion injection combined with docetaxel, pirarubicin and cyclophosphamide chemotherapy(TAC) in treatment of advanced breast cancer. Methods A total of 250 patients with advanced breast cancer admitted to Sichuan Provincial People′s Hospital from January 2017 to December 2018 were randomly divided into control group and observation group, with 125 cases in each group. The control group was treated with TAC regimen and the observation group was treated with brucea javanica oil emulsion injection additionally. Clinical efficacy, immune function, serum tumor indexes and adverse reactions were analyzed. Results After 4 cycles of treatment, clinical effective rate in the observation group was significantly higher than that in the control group［82.4%(103/125) vs 70.4%(88/125)］（P＝0.025）. Level of CD+8 increased after treatment and it was lower in the observation group than that in the control group［（29±4）% vs （35±4）%］; levels of CD+3, CD+4, CD+4/CD+8 decreased after treatment and they were higher in the observation group than those in the control group［（52±9）% vs （44±7）%, （32±5）% vs （28±4）%, （1.10±0.24） vs （0.80±0.17）］(all P＜0.05). Levels of serum carbohydrate antigen 15-3, carcinoembryonic antigen and vascular endothelial growth factor decreased after treatment and they were lower in the observation group than those in the control group(all P＜0.05）. There was no difference in the incidence of adverse reactions between groups(P=0.562). Conclusions Brucea javanica oil emulsion injection combined with TAC regimen is effective in the treatment of advanced breast cancer.It can reduce immune suppression and prevent the tumor progression without increasing adverse reactions.