关键词: 混合核苷片, 乳腺癌, 辅助化疗, 骨髓抑制

Abstract: Objective  To investigate the clinical effect of using mixed nucleoside tablets to prevent bone marrow suppression during AC adjuvant chemotherapy for breast cancer.
Methods  A total of 84 cases breast cancer patients who had received surgical treatment in our hospital from January 2018 to December 2019 were selected and all received adjuvant chemotherapy using AC regimen(21 days).The patients were randomly divided into the treatment group(42 patients) and the control group(42 patients).In the control group,if degree Ⅱ or above bone marrow suppression occurred during chemotherapy,recombinant human granulocyte colony stimulating factor injection(rh G-CSF) 5g/kg was administered subcutaneously.In the treatment group,mixed nucleoside tablets of 40mg/time were given orally,3 times/d,during chemotherapy.The blood routine examination was conducted on the 7th,9th and 11th day during 4 periods of chemotherapy.Changes of platelet,white blood cell and neutrophil count,degree of bone marrow suppression,occurrence time of bone marrow suppression and occurrence times of FN were compared and analyzed between 2 groups.
Results  Before treatment,there was no significant difference in the platelets,white blood cells and neutrophils between 2 groups(P>0.05).After chemotherapy,the counts of platelets,white blood cells and neutrophils of 2 groups decreased(P<0.05) Compared with the control group,the counts of platelets,white blood cells,and neutrophils in the treatment group increased to varying degrees in 4 periods of chemotherapy.Bone marrow suppression occurred in both groups after chemotherapy.The incidence of bone marrow suppression in the treatment group was 6.55%,and the control group was 13.10%.The incidence of bone marrow suppression in the treatment group was lower than the control group(P<0.05).The average response time of bone marrow suppression in the treatment group was later than that in the control group [(9.8±1.1)d vs.(7.5±1.4)d,t=8.372,P=0.000)].There were 2 people/period of FN in the treatment group,9 people/period in the control group,and fewer FNs in the treatment group than in the control group(P<0.05).
Conclusion  The mixed nucleoside tablets can effectively improve the myelosuppression of breast cancer patients with AC adjuvant chemotherapy and reduce the occurrence of FN.The use of mixed nucleoside tablets in AC adjuvant chemotherapy for low-risk breast cancer may become a new choice for FN low-risk adjuvant chemotherapy.

Key words: mixed nucleoside tablets, breast cancer, adjuvant chemotherapy, bone marrow suppression