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目的:比较奥曲肽联合来曲唑治疗与解救化疗的复发转移乳腺癌患者的临床效果及生活质量。方法:将生长抑素受体(SSTR)和雌激素受体(ER)或/和孕激素受体(PR)呈阳性的61例复发和转移乳腺癌患者分成奥曲肽联合来曲唑治疗组(来曲唑2.5 mg口服,1次/d,连续不间断;奥曲肽0.1 mg皮下注射,3次/d,每周用5 d停2 d。每月连用2周为1个疗程,共6个疗程)与解救化疗组(按NCCN指南不同的解救方案化疗,共6个疗程)。观察并比较两组的疗效、副反应,并用QOL方法评价两组的生活质量。结果:奥曲肽联合来曲唑治疗组临床有效率(CR+PR),获益率(CR+PR+SD),中位病变进展时间(TTP),中位治疗失败时间(TTF)及中位生存时间(MST)分别为29.0%(9/31),41.9%(13/31),6.6,5.6个月和18.7个月;解救化疗组分别为26.7%(8/30),43.3%(13/30),6.1,5.4个月和17.9个月,以上指标两组间差异均无统计学意义(均P>0.05)。但奥曲肽联合来曲唑组的药物毒副反应发生情况明显低于解救化疗组,生活质量明显优于解救化疗组(χ2=13.81,P=0.003)。结论:奥曲肽联合来曲唑治疗是晚期乳腺癌有效的治疗方法,能明显降低因采用解救化疗所产生的毒性反应,提高该类患者的生活质量。
Objective: To compare the clinical effects and quality of life of patients with recurrent or metastatic breast cancer treated with octreotide plus letrozole. METHODS: Sixty-one patients with recurrent and metastatic breast cancer who were positive for somatostatin receptor (SSTR), estrogen receptor (ER) and / or progesterone receptor (PR) were divided into octreotide combined with letrozole treatment 2.5mg omeprazole was administered orally once daily for 8 days. Octreotide was injected subcutaneously in 0.1 mg subcutaneously three times a day for 5 days and stopped for 2 days. One course of treatment was given for 2 weeks every month for a total of 6 courses) And rescue chemotherapy group (according to the NCCN guidelines different rescue chemotherapy, a total of 6 courses). The curative effects and side effects of the two groups were observed and compared. The QOL method was used to evaluate the quality of life in both groups. Results: The CR + PR, CR + PR + SD, TTP, TTF and median survival of octreotide combined with letrozole treatment group were significantly higher than those of control group (MST) were 29.0% (9/31), 41.9% (13/31), 6.6,5.6 months and 18.7 months, respectively. Rescue chemotherapy group was 26.7% (8/30) and 43.3% (13.3% 30), 6.1, 5.4 and 17.9 months respectively. There was no significant difference in the above indexes between the two groups (all P> 0.05). But the toxicity of octreotide combined with letrozole group was significantly lower than that of rescue chemotherapy group, and the quality of life was significantly better than that of rescue chemotherapy group (χ2 = 13.81, P = 0.003). Conclusion: The combination of octreotide and letrozole is an effective treatment for advanced breast cancer, which can significantly reduce the toxic reaction caused by the rescue chemotherapy and improve the quality of life of these patients.