目的 探讨戈舍瑞林联合AC-T方案治疗育龄期乳腺癌患者的疗效。方法 选取2024年1月—2025年1月东莞市人民医院育龄期乳腺癌患者94例，采用随机数字表法分为对照组和治疗组，每组各47例。对照组静脉滴注注射用盐酸多柔比星60 mg/m²和注射用环磷酰胺600 mg/m²，每2周为1个周期，给药4个周期；然后静脉滴注多西他赛注射液75 mg/m²，每2周为1个周期，给药4个周期。治疗组在对照组的基础上皮下注射醋酸戈舍瑞林缓释植入剂3.6 mg/次，1次/4周，首次化疗前1周至末次化疗后2周。两组均治疗8个周期。比较两组疗效[客观缓解率（ORR）、临床获益率（CBR）]、化疗前后肿瘤标志物[癌胚抗原（CEA）、糖蛋白125（CA125）、糖蛋白153（CA153）]水平、化疗前后血清卵泡刺激素（FSH）与雌二醇（E₂）水平、化疗结束后1年抗苗勒管激素（AMH）低水平和闭经发生率。结果 化疗后，治疗组ORR、CBR（65.96%、85.11%）和对照组（63.83%、87.23%）比较差异无统计学意义。化疗后，两组血清CEA、CA125、CA153水平均低于化疗前（P＜0.05）；化疗后两组血清CEA、CA125、CA153水平比较差异无统计学意义。化疗后，两组血清FSH水平高于化疗前，血清E₂水平低于化疗前（P＜0.05）；化疗后治疗组血清FSH水平低于对照组，血清E₂水平高于对照组（P＜0.05）。治疗组化疗结束后1年AMH低水平和闭经发生率（38.30%、23.40%）均低于对照组（72.34%、57.45%），差异有统计学意义（P＜0.05）。结论 戈舍瑞林联合AC-T方案能对育龄期乳腺癌患者卵巢功能起到保护作用，且不影响化疗近期疗效。

Objective To explorre the efficacy of goserelin combined with AC-T regimen in treatment of breast cancer in reproductive-aged women. Methods A total of 94 breast cancer patients of reproductive age admitted to Dongguan People’s Hospital from January 2024 to January 2025 were enrolled and divided into a control group and a treatment group using the random number table method, with 47 patients in each group. Patients in the control group received intravenous infusion of Doxorubicin Hydrochloride for injection, 60 mg/m² and Cyclophosphamide for injection 600 mg/m² every 2 weeks for 4 cycles. Subsequently, Docetaxel Injection was administered intravenously at 75 mg/m² every 2 weeks for another 4 cycles. On the basis of the above AC-T chemotherapy regimen, the treatment group received subcutaneous injection of Goserelin Acetate Sustained-release Implant 3.6 mg/time, once every 4 weeks. The initial injection was given 1 week before the first cycle of chemotherapy, and the last injection was administered 2 weeks after the final cycle of chemotherapy. Both groups completed a total of 8 treatment cycles. The two groups were compared in terms of therapeutic efficacy [objective response rate (ORR), clinical benefit rate (CBR)], serum levels of tumor markers [carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125), carbohydrate antigen 153 (CA153)] before and after chemotherapy, serum follicle-stimulating hormone (FSH) and estradiol (E₂) levels before and after chemotherapy, as well as the incidence of low anti-Müllerian hormone (AMH) level and amenorrhea at 1 year after chemotherapy completion. Results After chemotherapy, there was no statistically significant difference in ORR and CBR between the treatment group (65.96%, 85.11%) and the control group (63.83%, 87.23%). Serum levels of CEA, CA125 and CA153 were significantly decreased in both groups after chemotherapy (P < 0.05), whereas no intergroup differences were observed in these tumor marker levels post-treatment. After chemotherapy, serum FSH levels were elevated and E₂ levels were reduced in both groups versus pre-chemotherapy values (P < 0.05). The treatment group presented lower serum FSH and higher serum E₂ levels than the control group after chemotherapy (P < 0.05). At 1 year after chemotherapy, the incidences of low AMH level and amenorrhea in the treatment group were 38.30% and 23.40%, respectively, which were significantly lower than those in the control group (72.34% and 57.45%, P < 0.05). Conclusion Combination of goserelin and the AC-T regimen can effectively protect ovarian function in breast cancer patients of reproductive age, without compromising the short-term efficacy of chemotherapy.

R984

广东省基础与应用基础研究基金资助项目（2021A1515010156）；东莞市社会发展科技项目（20211800905282）