吡咯替尼和曲妥珠单抗治疗老年HER-2阳性乳腺癌患者的效果比较研究

A comparative study on efficacy of pyrotinib and trastuzumab in treatment of elderly patients with HER-2 positive breast cancer

中文关键词: 老年  HER-2阳性乳腺癌  吡咯替尼  曲妥珠单抗  临床疗效  不良反应

英文关键词: elderly  HER-2 positive breast cancer  pyrotinib  trastuzumab  clinical efficacy  adverse reaction

中文摘要:

      目的 本研究旨在比较吡咯替尼与曲妥珠单抗2种药物治疗老年HER-2阳性乳腺癌患者的临床疗效与不良反应差异.方法 选取2024年1月—2024年12月于张家口市第一医院就诊的90例老年HER-2阳性乳腺癌患者,采用随机信封法分为研究组(n=45)和对照组(n=45).研究组采用吡咯替尼治疗,对照组采用曲妥珠单抗治疗,2组治疗均持续4个疗程,共4个月.比较2组患者临床疗效、肿瘤标志物[癌胚抗原(CEA)、糖类抗原(CA15-3)、组织多肽特异性抗原(TPS)]水平、血清免疫功能指标[T淋巴细胞亚群(CD3+、CD4+、CD8+)]值、免疫球蛋白[免疫球蛋白M(IgM)、免疫球蛋白G(IgG)、免疫球蛋白A(IgA)]水平及不良反应.结果 治疗结束后,研究组患者治疗总有效率高于对照组(P＜0.05);与同组治疗前比较,2组患者血清CEA、CA15-3、TPS、IgM、IgG、IgA水平均降低,且研究组上述指标水平均低于对照组,差异均有统计学意义(P＜0.05);2组患者血清CD3+、CD4+、CD8+值均升高,且研究组CD3+、CD4+、CD8+值均高于对照组,差异均有统计学意义(P＜0.05);2组不良反应发生率差异无统计学意义(P＞0.05).结论 相较于曲妥珠单抗,吡咯替尼可能更有效控制老年HER-2阳性乳腺癌的疾病进展,降低肿瘤标志物水平,控制肿瘤负荷,改善患者免疫功能,且不加重不良反应.

英文摘要:

      Objective To compare the differences in clinical efficacy and adverse reactions between pyrotinib and tras-tuzumab in the treatment of elderly patients with HER-2 positive breast cancer.Methods 90 elderly patients with HER-2 posi-tive breast cancer treated in First Hospital of Zhangjiakou City from January 2024 to December 2024 were selected and randomly divided into study group(n=45)and control group(n=45)using the random envelope method.The study group was treated with pyrotinib,while the control group was treated with trastuzumab.Both groups underwent 4 treatment cycles,totaling 4 months.The clinical efficacy,levels of tumor markers[carcinoembryonic antigen(CEA),carbohydrate antigen 15-3(CA1 5-3),tissue polypeptide specific antigen(TPS)],serum immune function indicators[T lymphocyte subsets(CD3+,CD4+,CD8+)],immunoglobulins[immunoglobulin M(IgM),immunoglobulin G(IgG),immunoglobulin A(IgA)],and ad-verse reactions were compared between the two groups.Results The total effective rate in the study group was higher than that in the control group(P＜0.05).After treatment,the levels of serum CEA,CA1 5-3,TPS,IgM,IgG and IgA in both groups decreased,and the study group was significantly lower than the control(P＜0.05).The levels of serum CD3+,CD4+and CD8+in both groups increased after treatment,and the study group was significantly higher than the control(P＜0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion Com-pared with trastuzumab,pyrotinib may be more effective in controlling disease progression,reducing tumor marker levels,con-trolling tumor burden,and improving immune function in elderly patients with HER-2 positive breast cancer.It will not aggra-vate adverse reactions.