标题：紫杉醇联合拉帕替尼治疗HER-2阳性晚期乳腺癌的疗效及对患者生活质量的影响

      作者：张发良，王雪    上海孟超肿瘤医院肿瘤内科，上海 201800

      卷次： 2020年31卷13期

      【摘要】 目的 观察紫杉醇联合拉帕替尼治疗人表皮生长因子受体2 (HER-2)阳性晚期乳腺癌的临床疗效，并探讨其对患者生活质量的影响。方法 选择2018年12月至2019年12月上海孟超肿瘤医院肿瘤内科收治的60例HER-2阳性晚期乳腺癌患者为研究对象，按随机数表法分为观察组和对照组，每组30例。对照组采用安慰剂和紫杉醇治疗，观察组采用拉帕替尼与紫杉醇联合治疗。治疗期间观察两组患者的疾病进展情况，所有患者均空腹服药，持续治疗直至疾病进展或不良反应不能耐受。治疗3个月后对两组患者进行随访，评估两组患者近期疗效、健康相关生存质量表(SF-36)评分及不良反应情况。结果 观察组患者的治疗总有效率与疾病控制率分别为76.67%、93.33%，明显高于对照组的50.00%、70.00%，差异均具有统计学意义(P<0.05)；治疗前，观察组与对照组患者的生活质量评分分别为(58.22±9.23)分、(57.65±10.46)分，差异无统计学意义(P>0.05)；治疗后，观察组与对照组患者的生活质量评分分别为(78.21±10.12)分、(71.79±10.24)分，均较治疗前明显改善，且观察组生活质量改善效果优于对照组，差异均具有统计学意义(P<0.05)；随访期间两组均无死亡病例，且观察组的服药依从性为63.33%，高于对照组的50.00%，不良反应发生率为40.00%，低于对照组的56.67%，但差异均无统计学意义(P>0.05)。结论 紫杉醇联合拉帕替尼治疗HER-2阳性晚期乳腺癌的临床疗效较好，且能一定程度地提高患者的生活质量。
      【关键词】 晚期乳腺癌；人表皮生长因子受体2；拉帕替尼；紫杉醇；近期疗效；生活质量
      【中图分类号】 R737.9 【文献标识码】 A 【文章编号】 1003—6350（2020）13—1652—04

Clinical effect of paclitaxel combined with lapatinib in the treatment of HER-2 positive advanced breast cancerand its effect on the quality of life of breast cancer patients.
ZHANG Fa-liang, WANG Xue. Department of Oncology,Mengchao Tumor Hospital, Shanghai 201800, CHINA
【Abstract】 Objective To observe the clinical effect of paclitaxel combined with lapatinib in the treatment ofhuman epidermal growth factor receptor 2 (HER-2) positive advanced breast cancer, and to explore its impact on thequality of life of breast cancer patients. Methods From December 2018 to December 2019, sixty patients with HER-2positive advanced breast cancer were selected as the study subjects. According to method of random number table, thesubjects were divided into the observation group and control group, with 30 cases in each group. The control group wastreated with placebo plus paclitaxel, and lapatinib plus paclitaxel were used in the observation group. During the treat-ment, the disease progression of the two groups was observed. All patients took the medicine on an empty stomach, andthe treatment continued until the disease progression or adverse reactions could not be tolerated. Three months after thetreatment, the patients in the two groups were followed up to evaluate the short-term efficacy, health-related quality oflife (SF-36) score, adverse reactions, and metastasis. Results The total effective rate and disease control rate of the ob-servation group were 76.67% and 93.33%, respectively, which were significantly higher than corresponding 50.00% and70.00% of the control group (P<0.05). Before treatment, the quality of life scores of the patients in the observation groupwas (58.22±9.23) points versus (57.65±10.46) points of the control group (P>0.05). After treatment, the quality of lifescores of the patients in the observation group and the control group were (78.21±10.12) points and (71.79±10.24) pointsrespectively, which were significantly improved compared with those before treatment (P<0.05), and the improvementeffect of the quality of life in the observation group was better than that in the control group (P<0.05). There was nodeath in the two groups during the follow-up period, and the compliance of the observation group was 63.33% versus50.00% of the control group, and the incidence of adverse reactions was 40.00% versus 56.67% of the control group (allP>0.05). Conclusion Lapatinib combined with paclitaxel can be regarded as a treatment plan for HER2 positive ad-vanced breast cancer, which can improve the quality of life of patients to a certain extent.
      【Key words】 Advanced breast cancer; Human epidermal growth factor receptor 2 (HER-2); Lapatinib; Paclitax-el; Short term efficacy; Quality of life