多西他赛联合红色诺卡氏菌细胞壁骨架二线治疗晚期非小细胞肺癌的回顾性分析  

A retrospective analysis of docetaxelcombined with Nocardia rubra cell-wall skeletonin thesecond-line treatment of advanced non-small cell lung cancer

作　　者：周梅香 韩坤[1] 田聪[1] 朱洪玲 张洁[1] 陈庆宇 蒋梦怡 闵大六[1] ZHOU Meixiang;HAN Kun;TIAN Cong;ZHU Hongling;ZHANG Jie;CHEN Qingyu;JIANGMengyi;MIN Daliu(Department of Oncology,Sixth People’s Hospital,Shanghai Jiao Tong University,Shanghai 200233,China)

机构地区：[1]上海交通大学附属第六人民医院肿瘤内科,上海200233

出　　处：《肿瘤》2022年第9期617-625,共9页Tumor

基　　金：上海市卫生健康委员会卫生行业临床研究专项青年项目(20194Y0401);上海市第六人民医院东院院级科学研究基金(院人才2017001)

摘　　要：目的:探讨多西他赛联合红色诺卡氏菌细胞壁骨架(Nocardia rubra cell-wall skeleton,Nr-CWS)二线解救治疗晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)的疗效及其对患者免疫功能及生活质量评分的影响。方法:回顾性分析46例接受多西他赛联合Nr-CWS二线解救治疗的晚期NSCLC患者的临床资料。治疗方案为:单药多西他赛75 mg/m^(2)静脉滴注,d 1,每隔21 d重复1次;Nr-CWS400μg皮下注射,d 1,每隔7 d重复1次,直至化疗结束。所有患者均至少接受2个周期的治疗并根据实体瘤临床疗效评价标准评价疗效。检测治疗前后患者血液中的CD4^(+)、CD8^(+)和CD4^(+)CD8^(+)T淋巴细胞及自然杀伤(natural killer,NK)细胞水平,观察并比较治疗前和治疗2、4及6个周期后患者的生存质量评分和不良反应的发生情况。结果:46例入组患者中,完全缓解者有0例,部分缓解者有8例,疾病稳定者有24例;本研究治疗方案的客观有效率为17.4%,疾病控制率为69.6%;患者的中位无进展生存期为19周(95%置信区间:17.8~20.2周),中位总生存期为10个月(95%置信区间:9.5~10.9个月);治疗后患者血液中的CD4^(+)、CD4^(+)CD8^(+)T淋巴细胞及NK细胞水平比治疗前均明显升高(P<0.05);治疗2、4和6个周期后患者的生活质量评分明显高于治疗前(P<0.05),患者的生活质量有明显改善;未观察到由Nr-CWS所致的严重不良反应。结论:Nr-CWS联合多西他赛二线解救治疗晚期非小细胞肺癌患者可以取得较好的疗效,能有效改善患者的免疫功能,提高生活质量,值得临床推广。Objective:To investigate the curative effect of docetaxel combined with Nocardia rubra cell-wall skeleton(Nr-CWS)as a second-line therapy for advanced non-small cell lung cancer(NSCLC),and its influence on the immune function as well as the quality of life(QOL)score of NSCLC patients.Methods:The clinical data of 46 patients with advanced NSCLC who had received treatment of docetaxel combined with Nr-CWS as the second-line therapy were retrospectively analyzed.The patients were intravenously administered with docetaxel 75 mg/m^(2)every 21 dand subcutaneously injected with Nr-CWS 400μg every 7 d for at least 2 treatment cycles.Tumor response was evaluated according to response evaluation criteria in solid tumor(RECIST).The levels of CD4^(+),CD8^(+)and CD4^(+)CD8^(+)T lymphocytes as well asnatural killer(NK)cellsin patients’blood before and after treatment(2,4 and 6 treatment cycles)were recorded.The patients’QOL scores before and after treatment(2,4 and 6 treatment cycles)as well as the incidence of adverse events were compared.Results:Among the 46 patients studied,no complete response(CR)was observed,8 cases had partial response(PR),and 24 cases had steady disease(SD).The objective response rate(ORR)was 17.4%(8/46)and the disease control rate(DCR)was 69.6%(32/46).The median progression free survival(PFS)and overall survival(OS)time were 19 weeks(95%confidence interval:17.8-20.2)and 10 months(95%confidence interval:9.5-10.9)respectively.The levels of CD4^(+)andCD4^(+)CD8^(+)T lymphocytes as well as NK cells in patients’blood increased significantly(P<0.05)after treatment(2,4 and 6 treatment cycles).The patients’QOL scores were significantly higher(P<0.05)after treatment(2,4 and 6 treatment cycles),indicating obvious improvement in the patients’life quality.No severe adverse reaction caused by Nr-CWS was observed.Conclusion:Docetaxel combined with Nr-CWS had good curative effectas a second-line therapy for patients with advanced NSCLC.It could effectively improve the patients’immune function and life qu

关 键 词：晚期非小细胞肺癌 红色诺卡氏菌细胞壁骨架 疗效 免疫功能 生活质量 

分 类 号：R734.2[医药卫生—肿瘤]