2022 年第 3 期 第 17 卷

帕妥珠单抗联合曲妥珠单抗和长春瑞滨治疗老年人表皮生长因子受体2阳性转移性乳腺癌的临床效果

Clinical effect of pertuzumab combined with trastuzumab and vinorelbine on the treatment of elderly human epidermal growth factor receptor-2 positive metastatic breast cancer

作者：林红霞刘小平邓铖

英文作者：Lin Hongxia Liu Xiaoping Deng Cheng

单位：海南省海口市人民医院乳腺甲状腺外科，海口570208

英文单位：Department of Breast and Thyroid Surgery Haikou People′s Hospital Hainan Province Haikou 570208 China

关键词：转移性乳腺癌；人表皮生长因子受体2；帕妥珠单抗；曲妥珠单抗；长春瑞滨

英文关键词：Metastaticbreastcancer;Humanepidermalgrowthfactorreceptor-2;Pertuzumab;Trastuzumab;Vinorelbine

• 摘要：

• 目的 探讨帕妥珠单抗联合曲妥珠单抗和长春瑞滨治疗老年人表皮生长因子受体2（HER-2）阳性转移性乳腺癌的临床效果。方法  采用回顾性分析方法，收集2018年4月至2020年4月海南省海口市人民医院收治的86例老年HER-2阳性转移性乳腺癌患者的临床资料。根据治疗方法不同将其分为观察组（35例，接受帕妥珠单抗联合曲妥珠单抗和长春瑞滨治疗）和对照组（51例，接受曲妥珠单抗和长春瑞滨治疗）。比较2组患者治疗2个周期的近期效果和不良反应发生情况。收集随访资料（随访截止时间2020年12月），比较2组患者无进展生存期（PFS）。结果 观察组局部控制率及总有效率均高于对照组［91.4%（32/35）比72.5%（37/51）、74.3%（26/35）比51.0%（26/51）］，差异均有统计学意义（均P<0.05）。2组患者治疗期间肝功能异常、骨骼肌肉疼痛、心脏毒性、口腔炎症或溃疡、呕吐或腹泻发生率差异均无统计学意义（均P>0.05）；观察组粒细胞减少发生率高于对照组［54.3%（19/35）比27.5%（14/51）］，差异有统计学意义（P＜0.05）。随访（11±3）个月，Kaplan-Meier法并Log-rank检验分析结果显示，观察组PFS优于对照组［（19.8±3.2）个月比（12.8±2.8）个月］，差异有统计学意义（P＜0.05）。结论  帕妥珠单抗联合曲妥珠单抗和长春瑞滨治疗老年HER-2阳性转移性乳腺癌效果显著，可提高有效率和PFS，但粒细胞减少发生率高，临床使用过程中应密切观察患者粒细胞水平变化。

• Objective   To discuss the clinical effect of pertuzumab combined with trastuzumab and vinorelbine on the treatment of elderly human epidermal growth factor receptor-2(HER-2) positive metastatic breast cancer. Methods   From April 2018 to April 2020, clinical data of 86 elderly patients with HER-2 positive metastatic breast cancer admitted to Haikou People′s Hospital, Hainan Province were retrospectively analyzed. According to different treatment, patients were divided into the observation group(35 cases, receiving pertuzumab combined with trastuzumab and vinorelbine treatment) and the control group(51 cases, receiving trastuzumab and vinorelbine treatment). The short-term effects of treatment for 2 months and adverse reactions of the two groups were compared. Follow-up data (until December 2020) were collected, and the progression-free survival(PFS) of the two groups were compared. Results  The local control rate and total effective rate in the observation group were higher than those in the control group［91.4%（32/35） vs 72.5%（37/51）, 74.3%（26/35） vs 51.0%（26/51）］（both P<0.05）. There were no significant differences in the incidences of abnormal liver function, skeletal muscle pain, cardiotoxicity, oral inflammation or ulcers, and vomiting or diarrhea between the two groups during treatment(all P>0.05). The incidence of granulocytopenia in the observation group was higher than that in the control group［54.3%（19/35） vs 27.5%（14/51）］(P＜0.05). The follow-up time was (11±3)months. Kaplan-Meier method and Log-rank test analysis showed that PFS in the observation group was better than in the control group［（19.8±3.2）months vs （12.8±2.8）months］(P<0.05). Conclusions Pertuzumab combined with trastuzumab and vinorelbine has a significant effect on the treatment of elderly HER-2 positive metastatic breast cancer, which can improve the effective rate and PFS, but the incidence of granulocytopenia is high. The changes in the level of granulocytes in patients should be closely observed during clinical use.