肺癌伴乙型肝炎病毒感染患者化疗应用抗病毒药物临床意义分析  

Clinical analysis of application of antiviral drugs in lung cancer patients with hepatitis B virus infection who receiving chemotherapy

作　　者：郑蕾[1] 张贝贝[1] 宋正波[1] 何春晓[1] 娄广媛[1] 余新民[1] 赵珺[1] 石志永[1] 张沂平[1] 

机构地区：[1]浙江省肿瘤医院化疗中心,浙江杭州310022

出　　处：《中华肿瘤防治杂志》2014年第10期771-774,共4页Chinese Journal of Cancer Prevention and Treatment

基　　金：卫生部医药卫生科技发展研究中心课题基金(W2012FZ134);浙江省自然基金(LY13H160024);吴阶平医学基金(320.6750.11091;320.6750.11059)

摘　　要：目的：预防性使用抗病毒药物在感染乙肝病毒肺癌患者化疗过程中,探讨乙肝爆发及肝功能损伤的差异,以及对肺癌患者生存获益的影响。方法：回顾性分析2006-01-01-2012-12-31在浙江省肿瘤医院就诊122例感染乙肝病毒的肺癌患者,化疗前接受或不接受预防性使用抗病毒药物,χ2检验乙肝爆发及肝功能受损是否存在差异,Kaplan-Meier法进行生存分析和比较。结果：化疗前预防性使用抗病毒药物较未使用患者的乙肝爆发降低,P=0.002;患者肝功能受损降低,P=0.003。122例患者中位无进展生存期（median progression-free survival,mPFS）为3.47个月,95%CI为3.145～3.795;中位生存期（median overall survival,mOS）为18个月,95%CI为14.804～21.196。亚组分析结果显示,预防性使用抗病毒药物的乙肝肺癌患者一线化疗mPFS为3.57个月（95%CI为2.979～4.161）,无预防性使用的患者为3.370个月（95%CI为2.859～3.881）,差异无统计学意义,P=0.568。预防性使用抗病毒药物的乙肝肺癌患者的mOS为20个月（95%CI为16.105～23.895）,无预防性使用患者为16个月（95%CI为8.512～23.488）,差异无统计学意义,P=0.264。结论：预防性使用抗病毒药物在感染乙肝病毒肺癌患者化疗过程中,乙肝爆发及肝功能损伤较未预防性使用抗病毒药物的患者之间存在差异,对肺癌患者生存获益无明显影响。OBJECTIVE：To study the difference of hepatitis reactivation and liver dysfunction in hepatitis B positive lung cancer patients with antiviral drugs and without,and to investigate whether lung cancer patients carrying hepatitis B virus is a risk factors to survival benefit.METHODS：Of 122patients lung cancer patients carrying hepatitis B virus received chemotherapy and some of them had received prophylactic antivirus treatment before chemotherapy.Chi-square test was used to analysis the difference between the lung cancer patients with and without the use of antiviral drugs in hepatitis reactivation and liver dysfunction.Kaplan-Meier was used to analysis survival and comparison.RESULTS：There were statistical differences in hepatitis reactivation between the patients with prophylactic use of antiviral drugs and without（P= 0.02）,liver dysfunction had statistical differences between them too（P=0.003）.Median progression-free survival in first-line chemotherapy（mPFS）was 3.47month（95%CI：3.145-3.795）.The overall survival（OS）of patients with the treatment of icotinib was 18 month（95%CI：14.804-21.196）.Subgroup analysis in hepatitis B prophylactic antiviral drugs use patients PFS was 3.57months（95%CI：2.979-4.161）in no use patients PFS was 3.370months（95%CI： 2.859-3.881）,the statistical difference was not significant（P=0.568）.OS in prophylactic use of antiviral drugs was 20months（95%CI：16.105-23.895）and in no prophylactic use of antiviral drugs OS was 16months（95%CI：8.512-23.488）and there was no significant difference（P=0.264）.CONCLUCIONS：Receiving antiviral drugs or not makes lung cancer patients carrying the hepatitis B virus hepatitis reactivation and liver dysfunction different,no significant effect on survival benefit in patients with lung cancer.

关 键 词：抗病毒药物 肺癌 乙肝 化疗 

分 类 号：R734.2[医药卫生—肿瘤]