目的 探讨贝伐单抗联合曲妥珠单抗+紫杉醇(TH)方案化疗对人类表皮生长因子受体2(human epidermal growth factor receptor-2, Her-2)阳性的转移性乳腺癌患者外周血T细胞亚群和临床预后的影响。方法 选取Her-2阳性的乳腺癌患者100例,随机分为研究组和对照组;研究组采用贝伐单抗联合TH方案化疗,对照组仅采用TH方案化疗。随访终点为2年,主要观察指标为CD4+T细胞、CD8+T细胞、实体瘤疗效评价等级、无进展生存期和2年病死率。结果 两组治疗前后CD8+T细胞差异均无统计学意义。两组治疗前CD4+T细胞差异无统计学意义(P=0.422)。治疗后,研究组CD4+T细胞显著高于对照组(P=0.011)。研究组完全缓解、部分缓解、病情稳定和病情进展发生率分别为0.0%、36.0%、42.0%和22.0%,对照组为0.0%、18.0%、44.0%和38.0%。2年后,研究组9例死亡,病死率为18.0%,对照组20例死亡,病死率为40.0%,差异有统计学意义(P=0.015)。Wilcoxon检验显示研究组无进展生存期显著高于对照组(P=0.007)。结论 贝伐单抗联合TH方案化疗有助于改善Her-2阳性的转移性乳腺癌患者免疫功能和临床预后。
Abstract
Objective To investigate the effect of bevacizumab combined with TH chemotherapy on T cell subsets in peripheral blood and clinical prognosis in human epidermal growth factor receptor 2 (Her-2) positive patients with metastatic breast cancer.Methods Between Jan, 2012 and Jan, 2014, 100 patients with Her-2 positive metastatic breast cancer were prospectively recruited in this study. These patients were randomly assigned into a study group or a control group. The study group was treated with bevacizumab combined with TH chemotherapy while the control group was treated with TH chemotherapy alone. The patients were followed up for two years.The primary outcomes included CD4+T cells, CD8+T cells, solid tumor efficacy evaluation grades, progression free survival and 2-year mortality.Results There was no significant difference in CD8+T cells between the two groups before and after treatment. After treatment, the expression of CD4+T cells in the study group (P=0.422) was significantly higher than that in the control group (P=0.011). The rates of complete remission, partial remission, stable disease and progressive disease in the study groups were 0.00%, 36.00%, 42.00% and 22.00%, compared to 0.00%, 18.00%, 44.00% and 38.00% in the control group (P=0.025). Two years later, 9 patients in the study group died, and the mortality rate was 18.00%, while 20 patients in the control group died, and the mortality rate was 40.00%. The difference was statistically significant (P=0.015). Wilcoxon test showed that the duration of progression free survival in the study group was significantly longer than that in the control group (P=0.007).Conclusions The combination of bevacizumab and TH chemotherapy in patients with Her-2-positive metastatic breast cancer may help to improve the immune function and clinical prognosis.
关键词
转移性乳腺癌 /
人类表皮生长因子受体2 /
T细胞亚群 /
无进展生存期 /
生存质量
Key words
metastatic breast cancer /
human epidermal growth factor receptor-2 /
T cell subsets /
progression free survival /
quality of life
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