【摘要】 目的:观察并探讨曲妥珠单抗(herceptin,HCP)联合常规化疗治疗HER-2过度表达晚期贲门癌患者的临床疗效与药物安全性分析并化疗后2年内随访结果。方法:将我院2008年11月-2009年10月间入选的HER-2表达"++"及以上的72例晚期贲门癌患者随机单盲分为观察组(37例)与对照组(35例),对照组患者采用DCF(多西紫杉醇、顺铂、5-氟尿嘧啶)动脉灌注化疗方案,观察组在此基础上联合使用靶向药物HCP,对比两组化疗结束后临床效果、生活质量改善情况、化疗中药物不良反应及2年内生存率。结果:①观察组与对照组化疗效果与生活质量改善情况构成不同(P<0.05),观察组部分缓解比例(62.2%)、总有效率(64.9%)及生活质量改善比例(64.9%)均高于对照组水平(42.9%、42.9%、42.9%);②两组不良发生情况相仿,观察组出现Ⅱ度及以发热(52.8%)、寒战(45.9%)比例与出现心功能障碍的比例(10.8%)高于对照组比例(22.9%、17.1%、0.0%);③观察组与对照组24个月生存率分别为43.2%、20.0%,死亡者平均存活时间分别为(14.7±2.8)m、(12.5±2.1)m,两指标差别均具有统计学意义(P<0.05)。结论:HCP联合DCF化疗方案能明显改善HER-2过度表达晚期贲门癌患者疗效与生活质量,并延长患者生存时间,但应警惕联合用药中的心血管毒性。更多还原

【Abstract】 Objective: The paper was to conduct an observation and discussion on clinical effect and 2 years’ prognosis of her-ceptin(HCP) combined with conventional chemotherapy in treatment of advanced cardiac carcinoma patients with HER-2 over expression.Methods: 72 admitted cases with HER-2 expressing more than"++" ranging from Nov.2008 to Oct.2009 were randomized into observa-tional group(37 cases) and control group(35 cases) single blindly,and conventional DCF(Docetaxel+ cisplatin+5-fluorouracil) chemotherapy scheme was applied to control group,based on which,targeting drug HCP combined with DCF scheme was exerted to ob-servational group.Comparison after the completion of chemotherapy was conducted between 2 groups on indicators of curative effect,life quality,adverse drug reactions(ADR)and 2 years survival rate.Results: ①Composition of curative effect and life quality of 2 groups was different(P<0.05),partial remission rate,total efficiency and improvement of quality of life scale of observation group were 62.2%,64.9%,64.9% respectively,while control group were 42.9%,42.9%,42.9% correspondingly;②Similar ADRs were seen between 2 groups,but proportions of patients with fever(52.8%),chills(45.9%)classified into Ⅱdegree and above,and with cardiac dysfunction(10.8%) were higher than those of control group(22.9%,17.1%,0%);③24 months survival rates of 2 groups were 43.2%,20.0%,mean survival time of deaths were(14.7±2.8) m,(12.5 ±2.1) m,both of which were statistically significant(P< 0.05).Conclusion: HCP plus DCF chemotherapy scheme can improve curative effect and life quality,prolong survival time of advanced cardiac cancer patients with HER-2 advanced expression,but attention should be paid to cardiovascular toxicity.更多还原