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山东大学学报 (医学版) ›› 2019, Vol. 57 ›› Issue (11): 20-26.doi: 10.6040/j.issn.1671-7554.0.2018.1470

• • 上一篇    

吉非替尼联合化疗治疗50例晚期非小细胞肺癌患者的疗效

王建丽1,王筱静2,孙玉莲3,胡晓乐4,栾晓嵘5   

  1. 山东大学齐鲁医院1.呼吸科;2.耳鼻喉科;3.肝病科;4.手术室;5.护理部, 山东 济南 250012
  • 发布日期:2022-09-27
  • 通讯作者: 栾晓嵘. E-mail:luanxrong@163.com

Clinical effect of gefitinib combined with chemotherapy on patients with advanced non-small cell lung cancer

WANG Jianli1, WANG Xiaojing2, SUN Yulian3, HU Xiaole4, LUAN Xiaorong5   

  1. 1. Department of Respiratory Medicine;
    2. Department of ENT;
    3. Department of Hepatology;
    4. Operation Room;
    5. Nursing Department, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
  • Published:2022-09-27

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摘要： 目的 观察吉非替尼(伊瑞可)联合化疗治疗晚期非小细胞肺癌的疗效,对比治疗前后血清肿瘤标志物血清癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)、鳞状细胞癌相关抗原(SCC)水平的变化及疾病控制率。 方法 回顾性分析100例表皮生长因子受体(EGFR)突变阳性肺腺癌患者的病历资料,按治疗方案的不同分为观察组(n=50)和对照组(n=50),观察组采用培美曲塞+卡铂化疗联合伊瑞可治疗;对照组采用培美曲塞+卡铂化疗。治疗4个化疗周期后,评价临床疗效及患者血清中CEA、NSE、SCC的变化,比较两组患者的无进展生存期(PFS)差异。 结果 观察组客观有效率高于对照组(60.0% vs 36.0%,χ2=5.769,P=0.027)、疾病控制率高于对照组(86.0% vs 66.0%,χ2=5.482,P=0.034);两组经治疗后,血清CEA、NSE水平均较治疗前下降(t=-10.370,P<0.001;t=-4.802,P<0.001)。观察组患者的中位PFS长于对照组(10.9个月vs 7.9个月,χ2=45.183,P<0.001)。COX多因素分析显示,是否有吸烟史、ECOG评分、病例分组对 PFS 有统计学意义影响。无吸烟史患者的中位PFS长于有吸烟史患者(HR=1.929,95%CI:1.126~3.306,P=0.017); ECOG评分为 0~1分患者的中位PFS长于 ECOG评分≥2分患者(HR=2.059,95%CI:1.267~3.348,P=0.004);观察组患者的中位PFS长于对照组患者(HR=0.195,95%CI:0.118~0.320,P=0.001)。观察组不良反应发生率高于对照组(46.0% vs 36.0%),但差异无统计学意义(χ2=1.033,P=0.309)。 结论 吉非替尼(伊瑞可)联合化疗治疗晚期NSCLC患者疗效确切,可获得更好的疾病控制率,降低患者的血清CEA、NSE水平,且能延长患者的PFS,不良反应少,安全性高,值得临床推广应用。

关键词: 吉非替尼, 非小细胞肺癌, 靶向治疗, 表皮生长因子受体

Abstract: Objective To observe the efficacy of gefeitinib combined with chemotherapy on the advanced non-small cell lung cancer(NSCLC)patients, and to compare the changes of serum carcinoembryonic antigen(CEA), neuron-specific enolase(NSE), squamous cell cancer-related antigen(SCC)and disease control rate before and after treatment. Methods A total of 100 lung adenocarcinoma patients with epidermal growth factor receptor(EGFR)mutation-positive were divided into observation group(n=50)and control group(n=50)according to different treatment regimens. The observation group was treated with pemetrexed + carboplatin combined with gefeitinib, and the control group was treated with pemetrexed + carboplatin for 4 cycles to evaluate the clinical efficacy and the changes of CEA, NSE and SCC in the serum of patients, as well as to compare the difference in progression-free survival(PFS)between the two groups. Results Compared with the control group, the objective effective rate(60.0% vs 36.0%, χ2=5.769, P=0.027)and disease control rate(86.0% vs 66.0%, χ2=5.482, P=0.034)were higher. After treatment, the levels of CEA and NSE in serum decreased compared with those before treatment in both groups(t=-10.370, P<0.001; t=-4.802, 山 东 大 学 学 报 (医 学 版)57卷11期 -王建丽,等.吉非替尼联合化疗治疗50例晚期非小细胞肺癌患者的疗效 \=-P<0.001). The median PFS in the observation group was longer than that in the control group(10.9 months vs 7.9 months, χ2=45.183, P<0.001). The COX multivariate analysis showed that smoking history, ECOG score and case grouping had statistical significance on PFS. The median PFS of patients without smoking history was longer than those with smoking history(HR=1.929, 95%CI: 1.126-3.306, P=0.017); the median PFS of patients with ECOG scores being 0-1 was longer than those with ECOG scores≥2(HR=2.059, 95%CI: 1.267-3.348, P=0.004); the median PFS of patients in the observation group(HR=0.195, 95%CI)is longer than those in the control group(HR=0.195, 95%CI:0.118-0.320,P=0.001). The incidence of adverse reactions in the observation group was higher than those in the control group without the statistical difference(46.0% vs 36.0%, χ2=1.033, P=0.309). Conclusion Gefitinib combined with chemotherapy is effective in the treatment of advanced NSCLC patients with better disease control rate, decreased serum CEA and NSE levels and prolonged PFS of patients. The method is safe and has fewer adverse reactions, worthy of promoting clinically.

Key words: Gifitinib, Non-small cell lung cancer, Target biotherapy, Epidermal growth factor receptor

中图分类号: 

  • R734.2
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