唑来膦酸联合依西美坦治疗激素受体阳性老年乳腺癌的疗效及安全性研究

Efficacy and safety of zoledronic acid combined with Exemestane in treatment of elderly patients with hormone receptor-positive breast cancer

摘要:

目的 探讨唑来膦酸联合依西美坦治疗激素受体阳性老年乳腺癌的疗效及安全性。方法 选取2018年4月—2021年4月海口市人民医院收治的106例激素受体阳性老年乳腺癌患者，按照随机数字表法将患者分为对照组和观察组，每组53例。对照组接受单纯依西美坦治疗；观察组在对照组基础上联合唑来膦酸治疗。统计两组治疗疗效和不良反应，观察两组治疗前后免疫功能指标（CD3⁺、CD4⁺、CD4⁺/CD8⁺）、性激素［雌二醇（E₂）、孕酮（P）、睾酮（T）］、骨标志物［β-胶原特殊序列（β-Cross Laps）、总骨Ⅰ型前胶原氨基端延长肽（PⅠNP）］变化。结果 观察组治疗总有效率高于对照组（P <0.05）；观察组治疗后CD3⁺、CD4⁺、CD4⁺/CD8⁺高于对照组（P <0.05），CD8⁺低于对照组（P <0.05）；观察组E₂、P、T水平低于对照组（P <0.05）；观察组治疗后血清β-Cross Laps、PⅠNP水平低于对照组（P <0.05）；两组并发症总发生率比较，差异无统计学意义（P > 0.05）。结论 唑来膦酸联合依西美坦用药治疗激素受体阳性老年乳腺癌疗效较佳，可提高免疫功能，改善骨代谢水平，且未明显增加不良反应，安全有效。

Abstract:

Objective To analyze the efficacy and safety of zoledronic acid combined with Exemestane in the treatment of hormone receptor positive elderly breast cancer patients.Methods A total of 106 cases of hormone receptor positive elderly breast cancer patients from April 2018 to April 2021 in Haikou City People's Hospital were divided into two groups according to the random number table method. The control group (53 cases) received zoledronic acid treatment, and the observation group (53 cases) received Exemestane combined treatment on the basis of the above. The therapeutic effects and adverse reactions of the two groups were counted. The immune function, levels of sex hormones [estradiol (E2), progesterone (P), and testosterone (T) ], bone markers [type Ⅰcollagen cross-linked carboxyl amino-terminal peptide (β-Crosslap), and total bone type Ⅰ procollagen amino-terminal extension peptide (PⅠNP)] were observed before and after treatment.Results The total effective rate of treatment was higher in the observation group than in the control group (P < 0.05); CD3⁺, CD4⁺, CD4⁺/CD8⁺ were higher, and CD8⁺, E2, P, and T levels were lower in the observation group than in the control group after treatment (P < 0.05); serum β-Cross Laps and PⅠNP levels were lower in the observation group than in the control group after treatment (P < 0.05); complications in both groups incidence, the difference was not statistically significant (P > 0.05).Conclusion Zoledronic acid combined with Exemestane is effective and safe in the treatment of hormone receptor positive elderly breast cancer, in that it can improve immune function without affecting bone metabolism and without significantly increasing adverse reactions.