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目的观察赫赛汀(HCP)联合CEF(环磷酰胺+表阿霉素+5-氟尿嘧啶)新辅助化疗方案(NACT)治疗HER-2过表达乳腺癌患者的阶段性疗效。方法 68例入选患者随机分为观察组(36例)和对照组(32例),对照组给予CEF NACT方案,观察组在此基础上联合应用HCP,化疗4个周期后,比较患者HER-2胞外水平、Karnofsky评分、临床疗效和药物不良反应。结果 (1)NACT完成后,观察组患者HER-2胞外段配体结合域(HER-2 ECD)水平较之对照组下降,且KPS评分高于对照组,二者差异均具有统计学意义(P<0.05)。(2)两组患者完成NACT治疗后,观察组总体有效率(69.4%)高于对照组(43.8%,P<0.05)。(3)两组患者在心功能异常、过敏性皮疹、发热或寒战等不良反应方面差异有统计学意义(P<0.05)。结论 HCP联合CEF方案能降低HER-2过表达乳腺癌患者HER-2表达水平,改善患者术前状态,同时应警惕HCP的心脏毒性。
Objective To observe the staged efficacy of Herceptin (HCP) combined with CEF (cyclophosphamide + epirubicin + 5-fluorouracil) neoadjuvant chemotherapy (NACT) in the treatment of HER-2 overexpressing breast cancer patients. Methods A total of 68 selected patients were randomly divided into observation group (36 cases) and control group (32 cases). The control group received CEF NACT regimen. On the basis of this study, HCP was given to the observation group. After 4 cycles of chemotherapy, HER-2 Extracellular levels, Karnofsky score, clinical efficacy and adverse drug reactions. Results (1) The levels of HER-2 ECD in the observation group decreased compared with the control group after NACT was completed, and the KPS score was higher than that of the control group, the differences were statistically significant (P <0.05). (2) The total effective rate (69.4%) in the observation group after NACT treatment was higher than that in the control group (43.8%, P <0.05). (3) There was significant difference between the two groups in adverse reactions such as cardiac dysfunction, allergic rash, fever or chills (P <0.05). Conclusions HCP combined with CEF regimen can reduce the expression of HER-2 in HER-2 overexpressing breast cancer patients and improve the preoperative state of the patients. At the same time, we should be alert to the cardiotoxicity of HCP.