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目的 探讨曲妥珠单抗联合长春瑞滨在人表皮生长因子受体2(HER-2)阳性晚期乳腺癌患者中的治疗效果.方法 选择2010年4月至2013年4月91例紫杉醇方案治疗失败的HER-2阻性晚期乳腺癌患者,其中接受曲妥珠单抗联合长春瑞滨治疗的患者45例(长春瑞滨组),接受曲妥珠单抗联合卡培他滨治疗的患者46例(卡培他滨组).比较两组患者疗效、不良反应和3年生存率等指标.结果 两组临床获益率比较差异无统计学意义(P＞0.05),但长春瑞滨组客观有效率高于卡培他滨组[44.44％(20/45)比23.91％(11/46)],差异有统计学意义(P=0.039).两组不良反应发生情况比较差异无统计学意义(P＞0.05).两组3年生存率比较差异无统计学意义(P=0.252).结论 在HER-2阳性晚期乳腺癌患者治疗中,曲妥珠单抗联合长春瑞滨或卡培他滨在不良反应和3年生存率方面无明显差异,但曲妥珠单抗联合长春瑞滨客观有效率优于曲妥珠单抗联合卡培他滨.“,”Objective To explore the clinical efficacy of trastuzumab combined with vinorelbine therapy in the treatment of advanced breast cancer with human epithelial growth factor receptor-2 (HER-2) positive.Methods From April 2010 to April 2013,91 advanced breast cancer patients who failed in the paclitaxel therapy received trastuzumab plus vinorelbine (45 cases,vinorelbine group) or capecitabine (46 cases,capecitabine group).The treatment efficacy,toxic effects and 3-year survival rate in two groups were compared.Results The clinical benefit rate in two groups had no significant difference (P ＞ 0.05),but objective response rates in vinorelbine group was higher than that in capecitabine group:44.44％(20/45) vs.23.91％(11/46),and there was significant difference (P =0.039).The toxic effects in two groups had no significant difference (P ＞ 0.05).The 3-year survival rate in two groups had no significant difference (P =0.252).Conclusions In the treatment of HER-2 positive advanced breast cancer,trastuzumab plus vinorelbine or capecitabine shows no significant differences in adverse reaction or in 3-year survival rate.However,trastuzumab plus vinorelbine shows better objective response rate compared with trastuzumab plus capecitabine.