Department of Thyroid and Breast Surgery, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, 510000, China.
Department of Infectious Diseases, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, 510000, China.
Breast. 2017 Oct;35:191-195. doi: 10.1016/j.breast.2017.08.001. Epub 2017 Aug 8.
Chemotherapy has greatly improved the prognosis of breast cancer patients. However, it may also result in undesirable side effects such as hepatitis virus reactivation. Little information is available on the liver toxicity of chemotherapy and targeted therapy for breast cancer patients with hepatitis virus (HBV/HCV) infection.
We performed a retrospective survey of 835 patients diagnosed with breast cancer between January 2010 and December 2015 at our institution. All patients had been screened for HBV/HCV infection at the time of breast cancer diagnosis. We retrospectively investigated the toxicity of chemotherapy and the changes in HBV/HCV load based on a medical record review.
52 patients with positive anti-HBV antibody test and 21 patients with positive anti-HCV antibody tests received chemotherapy. 762 patients without HBV and HCV infection served as the control group. The morbidity of liver toxicity and disruptions in chemotherapy attributable to liver toxicity were not significantly different among control group, HBV group and HCV groups (27.7% vs 34.6% vs 42.9%, P = 0.189 and 5.0% vs 9.6% vs 9.5%, P = 0.173, respectively). No patients presented with HBV/HCV reactivation.
Breast cancer patients with HCV can be treated with chemotherapy and targeted therapy with trastuzumab. Breast cancer patients with HBV who accept antiviral therapy can be treated with chemotherapy and targeted therapy with trastuzumab and patients can benefit from prophylactic antiviral therapy before chemotherapy. However, a multidisciplinary cooperation and closely monitoring liver function during the course of chemotherapy may benefit patients.
化疗极大地改善了乳腺癌患者的预后。然而,它也可能导致肝炎病毒再激活等不良副作用。关于化疗和针对合并乙型肝炎病毒(HBV)/丙型肝炎病毒(HCV)感染的乳腺癌患者的靶向治疗的肝毒性信息有限。
我们对 2010 年 1 月至 2015 年 12 月在我院确诊为乳腺癌的 835 例患者进行了回顾性调查。所有患者在诊断乳腺癌时均接受了 HBV/HCV 感染筛查。我们通过病历回顾,回顾性调查了化疗的毒性和 HBV/HCV 载量的变化。
52 例抗 HBV 抗体检测阳性和 21 例抗 HCV 抗体检测阳性的患者接受了化疗。762 例无 HBV 和 HCV 感染的患者作为对照组。在对照组、HBV 组和 HCV 组中,肝毒性的发病率和因肝毒性中断化疗的比例无显著差异(27.7%比 34.6%比 42.9%,P=0.189;5.0%比 9.6%比 9.5%,P=0.173)。无患者出现 HBV/HCV 再激活。
接受抗病毒治疗的 HBV 乳腺癌患者可以接受曲妥珠单抗化疗和靶向治疗,接受预防性抗病毒治疗前可以接受曲妥珠单抗化疗和靶向治疗。然而,多学科合作和密切监测化疗过程中的肝功能可能对患者有益。