TAC方案联合内分泌新辅助治疗对HR阳性/HER-2阴性乳腺癌的疗效分析

Analysis of the Therapeutic Effect of TAC Regimen in Combination with Neoadjuvant Endocrine Therapy for HR-Positive/HER-2-Negative Breast Cancer

摘要: 目的：观察TAC方案联合内分泌新辅助治疗对HR阳性/HER-2阴性乳腺癌的疗效。方法：选取2020年9月至2024年6月125例HR阳性/HER-2阴性乳腺癌患者，分观察组60例、对照组65例，观察组据月经状态再分为绝经前绝经后，对照组行TAC化疗6周期，观察组在此基础上加内分泌治疗，新辅助治疗6周期后手术，对观察组与对照组两组间、观察组组内及不同病理分期的观察组与对照组在MP分级、病理完全缓解(pCR)率、ORR、Ki-67变化值、不良反应发生率进行分析比较。结果：观察组与对照组pCR率无统计学差异，观察组ORR高于对照组(78.33% vs 60.00%)，差异有统计学意义(χ² = 4.885, P = 0.021)，观察组Ki-67变化值大于对照组(25.45% ± 11.51% vs 20.34% ± 11.10%)，差异有统计学意义(t = 2.527, P = 0.013)，潮热发生率观察组高于对照组。观察组Stage II的ORR高于Stage III (92.86% vs 44.44%)，差异有统计学意义(P < 0.000)，观察组Stage II Ki-67变化值大于Stage III (27.38% ± 11.75% vs 20.94% ± 2.31%)，差异有统计学意义(t = 2.037, P = 0.046)，其余各项结果无统计学差异；观察组内绝经前、后患者各项结果无统计学差异。结论：化疗联合内分泌新辅助治疗可以提高HR阳性/HER-2阴性乳腺癌的ORR率、改善MP分级以及降低Ki-67，且安全性良好。

Abstract: Objective: To observe the therapeutic effect of the TAC regimen combined with neoadjuvant endocrine therapy in HR-positive/HER-2-negative breast cancer. Methods: A total of 125 patients with HR-positive/HER-2-negative breast cancer from September 2020 to June 2024 were selected and divided into an observation group (n = 60) and a control group (n = 65). The observation group was further divided into premenopausal and postmenopausal subgroups according to menstrual status. The control group received 6 cycles of TAC chemotherapy, and the observation group received endocrine therapy in addition to TAC chemotherapy. Surgery was performed after 6 cycles of neoadjuvant therapy. The MP grade, pathological complete response (pCR) rate, objective response rate (ORR), change value of Ki-67, and incidence of adverse reactions were analyzed and compared between the observation group and the control group, within the observation groups, and between the observation group and the control group in different pathological stages. Results: There was no significant difference in the pCR rate between the observation group and the control group. The ORR of the observation group was higher than that of the control group (78.33% vs 60.00%), with a significant difference (χ² = 4.885, P = 0.021). The change value of Ki-67 in the observation group was greater than that in the control group (25.45% ± 11.51% vs 20.34% ± 11.10%), with a significant difference (t = 2.527, P = 0.013). The incidence of hot flashes in the observation group was higher than that in the control group. In the observation group, the objective response rate (ORR) in Stage II was higher than that in Stage III (92.86% vs 44.44%), and the difference was statistically significant (P < 0.000). The change value of Ki-67 in Stage II of the observation group was greater than that in Stage III (27.38% ± 11.75% vs 20.94% ± 2.31%), and the difference was statistically significant (t = 2.037, P = 0.046). There was no statistical difference in the remaining results. There was no difference in the results between premenopausal and postmenopausal patients within the observation group. Conclusion: Chemotherapy combined with neoadjuvant endocrine therapy can improve the ORR, improve the MP grade, and reduce Ki-67 in HR-positive/HER-2-negative breast cancer, with good safety.