The Relationship Between Hemoglobin Changes During First-line Chemotherapy For Advanced Breast Cancer And The Efficacy And Prognosis Of Chemotherapy

Objective: To explore the relationship between the changes of hemoglobin in the first-line chemotherapy of advanced breast cancer patients and the efficacy and prognosis of chemotherapy,and to further clarify the risk factors of anemia after chemotherapy.Methods: Collect the qinghai university affiliated hospital in June 2015 to June 2019 diagnosed with late stage(?)three negative in 84 cases of breast cancer patients.They were divided into five groups based on the hemoglobin trajectory during chemotherapy.Include(1.persistent-anemia;2.mild anemia;3.Normal Hb;4.low normal Hb;5.improved-anemia).General datas,Tumor lesion size,chemotherapy regimen,chemotherapy cycle,site of recurrence and metastasis,and prognostic indicators(chemotherapy effect,PFS and clinical benefit rate)were collected for each group.Secondly,the hemoglobin(Hb)level after chemotherapy was divided into normal group,mild anemia group,moderate anemia group and severe anemia group to analyze the general information and clinical characteristics,further explore the related factors of anemia after chemotherapy,and conduct statistical analysis on the data.Results:Patients in each group were grouped by hemoglobin trajectory,and there are no statistically significant differences in age,nationality,menstrual status,BMI,lesion size,chemotherapy regimen and site of recurrence and metastasis(P>0.05).There are statistically significant differences between groups in hemoglobin levels before chemotherapy and the duration of chemotherapy.For the indicators with statistical differences,i.e.,Hb before chemotherapy and chemotherapy cycle,the Hb trajectory grouping was taken as the dependent variable and ordered logistics regression was performed.The results showed that only Hb before chemotherapy had significant influence on the coefficient.The analysis results: firstly on the different of hemoglobin group,the results show that different types of hemoglobin trajectory of PFS have significant statistical difference(P < 0.05),PFS was the longest in the normal Hb group,and PFS in the persistent anemia group,mild anemia group and lower than normal Hb group were significantly lower than PFS in the normal Hb group compared with the normal Hb group,with significant statistical difference(P < 0.05).The clinical benefit rates of different Hb trajectory types were statistically significant(P < 0.05),and the clinical benefit rates of normal Hb and improved anemia groups were the highest.There were significant statistical differences in the duration of clinical remission in each group of effective patients with different Hb locus types(P < 0.05).Secondly the groups were grouped by hemoglobin(Hb)levels after chemotherapy,the results of multivariate analysis indicated that: Platinum chemotherapy drugs in the plan are more prone to anemia in moderate anemia after chemotherapy compared with normal Hb,at the same times in the course of chemotherapy,the decrease value of Hb does not exceed 20g/L,and anemia is not easy after chemotherapy.Conclusion:1.The change trajectories of different hemoglobin in advanced breast cancer patients during first-line chemotherapy were not related to the efficacy of chemotherapy,but were probably related to the PFS,the clinical benefit rate and the remission duration of each group.The change trajectories of different hemoglobin during chemotherapy may have predictive value for the prognosis.2.In the first-line chemotherapy of advanced breast cancer patients,platinum is more prone to anemia in the chemotherapy plan,and the decrease of Hb value over 20g/L in the chemotherapy process often indicates that anemia is more likely to occur,which should be concerned by clinicians.