摘要
目的:探究PD-1抑制剂卡瑞利珠单抗联合TP方案用于老年三阴性乳腺癌(TNBC)患者术前新辅助化疗(NAC)的临床疗效及安全性。方法:选择2020年1月—2022年1月河北医科大学附属沧州市中心医院收治的TNBC患者64例,按照所接受的治疗方案分为对照组(n=33)和观察组(n=31)。对入组的所有患者在术前均给予TP NAC方案,观察组在TP方案基础上给予PD-1抑制剂卡瑞利珠单抗。在NAC完成后1周,两组患者均实施乳腺癌改良根治术,术后继续进行4个周期的辅助化疗。比较观察组和对照组NAC前后Ki-67阳性情况,记录比较两组手术时长、术中出血量、客观缓解率(ORR)、疾病控制率(DCR)、无进展生存期(PFS)和总生存期(OS)及不良反应发生情况。结果:NAC后观察组和对照组Ki-67阳性率较NAC前均有下降,其中,对照组与NAC前比较,差异有统计学意义(P<0.05),但观察组与NAC前比较,差异无统计学意义(P>0.05);观察组的手术时长短于对照组[(59.08±9.27)min vs.(87.01±9.35)min],出血量少于对照组[(109.35±11.85)mL vs.(174.77±14.67)mL],差异均有统计学意义(P<0.05);观察组ORR(74.2%vs.48.5%)、DCR(90.3%vs.66.7%)均高于对照组(P>0.05)。由于随访时间较短,两组OS未达到,观察组PFS未达到,对照组的中位PFS为9.70个月[95%CI(9.16,10.24)],两组比较差异有统计学意义(P<0.05)。观察组和对照组不良反应发生率比较,差异均无统计学意义(P>0.05)。结论:PD-1抑制剂卡瑞利珠单抗联合TP方案用于老年TNBC患者术前NAC的临床疗效较好,可以改善患者预后,安全性相对可控。
Objective:To explore the clinical efficacy and safety of PD-1 inhibitor Camrelizumab combined with TP protocol for preoperative neoadjuvant chemotherapy(NAC)in elderly patients with triple-negative breast carcinoma(TNBC).Method:A total of 64 patients with TNBC admitted to Cangzhou Central Hospital Affiliated to Hebei Medical University from January 2020 to January 2022 were selected and divided into control group(n=33)and observation group(n=31)according to the accepted treatment protocol.All the enrolled patients were given TP NAC protocol before surgery,and the observation group was given PD-1 inhibitor Camrelizumab on the basis of TP protocol.1 week after NAC was completed,patients in both groups underwent modified radical mastectomy,and continued to receive adjuvant chemotherapy for four cycles after surgery.Ki-67 positivity situation before and after NAC were compared between the observation group and the control group.Operation duration,intraoperative bleeding volume,objective response rate(ORR),disease control rate(DCR),progression free survival(PFS),overall survival(OS)and adverse reactions were recorded and compared between the two groups.Result:The positive rates of Ki-67 in the observation group and the control group after NAC were significantly lower than those before NAC,and among them,there was statistical significance in control group compared with before NAC(P<0.05),but there was no statistical significance in observation group compared with before NAC(P>0.05).The operation duration in the observation group was shorter than that in the control group[(59.08±9.27)min vs.(87.01±9.35)min],and the intraoperative bleeding volume in the observation group was less than that in the control group[(109.35±11.85)mL vs.(174.77±14.67)mL],the differences were statistically significant(P<0.05).ORR(74.2%vs.48.5%)and DCR(90.3%vs.66.7%)in observation group were higher than those in control group(P<0.05).Due to the short follow-up time,OS was not reached in the two groups,PFS in the observation group was not reac
作者
殷雨来
张恒乐
任悦
张辉
张晓宇
YIN Yulai;ZHANG Hengle;REN Yue;ZHANG Hui;ZHANG Xiaoyu(Cangzhou Central Hospital Affiliated to Hebei Medical University,Cangzhou 061000,China;不详)
出处
《中国医学创新》
CAS
2023年第34期22-26,共5页
Medical Innovation of China
