Comparison Of Efficacy Of THL And TCH Regimen In Neoadjuvant Treatment Of Her-2 Positive Breast Cancer

ObjectiveIn China,breast cancer has become the first malignant tumor in women,which seriously affects women's health.The purpose of this paper is to explore the difference and safety of neoadjuvant chemotherapy regimen for Her-2 positive breast cancer in Henan area.MethodsFrom January 2017 to December 2017,76 patients with stage?~?breast cancer admitted in the Department of Breast surgery,first affiliated Hospital of Zhengzhou University,were randomly divided into two groups,one used Docetaxel plus Trastuzumab and lapatinib(THL),and the other used docetaxel,carboplatin,Tritozumab(TCH)for neoadjuvant treatment.According to the RECISTl-1 criteria for evaluating,the effect of the two regimens was evaluated as one chemotherapy cycle in 21 days,2~6 cycles in preoperative chemotherapy,and the whole course of chemotherapy was completed after operation.All patients underwent relevant examinations before operation,such as blood routine examination,liver function and renal function.The electrolyte examination should be within the normal range.In addition,CT scan,head MRI and bone scan should be performed on the chest and abdomen of pelvic color Doppler ultrasound,and SPECT/CT examination should be performed when necessary to identify the metastasis of distant organs.Liver and kidney function,electrocardiogram(ECG),color Doppler echocardiography(CDFI),and toxicity were evaluated at the same time.ResultsThere was no significant difference in hormone receptor status and TNM stage between different chemotherapy regimens(P>0.05).There was no significant difference between hormone receptor status and axillary lymph node metastasis(?~20.400 P<0.527).The most common adverse reactions in patients with THL regimen were rash,diarrhea,and liver dysfunction.Common adverse reactions in patients with TCH regimen are blood system side effects,such as thrombocytopenia and elevated alanine aminotransferase.The incidence of rash,diarrhea and thrombocytopenia were significantly different between the two chemotherapy regimens(P<0.05).Conclusions1.In Henan area,the effective rate of THL scheme is 87.1%and the effective rate of TCH scheme is 86.4%.There was no significant difference between the two neo-adjuvant chemotherapy regimens.2.The expression of hormone receptor,tumor TNM stage and menstruation had no effect on the efficacy of neoadjuvant chemotherapy.3.For adverse reactions,most of the THL regimen were diarrhea and rashes;TCH regimen were mainly thrombocytopenia and the elevation of alanine aminotransferase(ALT)was.THL regimen is more likely to cause rash and diarrhea than TCH regimen,and the incidence of thrombocytopenia in TCH regimen was higher than that in THL regimen.