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目的观察曲妥珠单抗治疗人表皮生长因子受体2(HER2)阳性晚期转移性乳腺癌的心脏毒性。方法回顾性收集102例用曲妥珠单抗治疗HER2阳性晚期转移性乳腺癌住院患者的临床资料,包括一般情况、临床疗效、左心室射血分数(LVEF)。分析影响LVEF变化的临床因素,以及心脏毒性药物不良反应的发生情况。结果 102例患者首次曲妥珠单抗治疗完全缓解7例(6.86%),部分缓解73例(71.57%)。LVEF基线值为(72.85±4.64)%,持续使用曲妥珠单抗的患者LVEF值第21个月及第39个月到达谷点,分别为(66.05±5.96)%和(65.15±3.38)%。首次使用含曲妥珠单抗无进展生存期(PFS)和使用曲妥珠单抗时间是影响LVEF下降的临床因素(均P<0.05),整个LVEF监测过程中曲妥珠单抗相关的心脏毒性药物不良反应累积发生率为14.71%(15例),未发生曲妥珠单抗治疗导致的心力衰竭,无曲妥珠单抗治疗相关的死亡。结论使用曲妥珠单抗治疗晚期乳腺癌,心脏功能呈现周期性下降及恢复趋势,心脏毒性药物不良反应发生率平稳,长期使用耐受性及安全性良好。
Objective To observe the cardiotoxicity of trastuzumab in the treatment of human epidermal growth factor receptor 2 (HER2) positive advanced metastatic breast cancer. Methods The clinical data of 102 hospitalized patients with advanced HER2-positive advanced breast cancer who were treated with trastuzumab were retrospectively collected. The general conditions, clinical efficacy and left ventricular ejection fraction (LVEF) were included. Analyze the clinical factors affecting the changes of LVEF and the occurrence of adverse reactions of cardiotoxic drugs. Results In the 102 patients, the first complete trastuzumab treatment was relieved in 7 cases (6.86%) and in 73 cases (71.57%) partially relieved. The baseline LVEF was (72.85 ± 4.64)% in patients receiving continuous trastuzumab, reaching (66.05 ± 5.96)% and (65.15 ± 3.38)% at 21 and 39 months respectively . The first-time use of trastuzumab with progression-free survival (PFS) and the use of trastuzumab timing were the clinical factors that affected the decline in LVEF (all P <0.05), and trastuzumab-associated heart during the entire LVEF monitoring The cumulative incidence of toxic drug adverse reactions was 14.71% (15 cases), no heart failure caused by trastuzumab treatment, and no death associated with trastuzumab treatment. Conclusions Trastuzumab treatment of advanced breast cancer, cardiac function showed a cyclical decline and recovery trend, the incidence of adverse reactions of cardiac toxic drugs stable, long-term use tolerance and good safety.