干预循环肿瘤细胞对小细胞肺癌疗效的影响研究  

Efficacy of Intervention of Circulating Tumor Cells on Small Cell Lung Cancer

作　　者：杨政[1] 刘春花[1] 李晶[2] 马晓平[2] 黄伟[2] 巩平[2] 

机构地区：[1]石河子大学医学院,新疆石河子市832000 [2]石河子大学医学院第一附属医院肿瘤内科

出　　处：《中国全科医学》2014年第33期3953-3956,共4页Chinese General Practice

基　　金：新疆生产建设兵团科技计划专项基金(2012BA042);世界卫生组织国际临床试验注册项目(ChiCTR-TRC-13003553)

摘　　要：目的探讨干预循环肿瘤细胞(CTCs)的数量是否能改善小细胞肺癌(SCLC)患者的客观缓解率(ORR)和疾病控制率(DCR)。方法选取2012年1月—2013年6月石河子大学医学院第一附属医院收治的45例SCLC患者,采用随机数字表法分为对照组(23例)和试验组(22例)。对照组根据影像学和血清学评估结果〔实体瘤的疗效评价标准(RECIST)〕决定继续按原方案治疗或者更换治疗方案;试验组根据CTCs检测结果决定按原方案治疗或更换治疗方案。比较两组治疗效果、Karnofsky功能状态评分(KPS)。结果 45例SCLC患者首次CTCs检出37例,阳性率为82%。其中对照组20例(87%),试验组17例(77%),差异无统计学意义(χ2=0.721,P=0.396)。治疗2个周期后,45例SCLC患者CTCs变化评价和RECIST评价的疗效比较,差异有统计学意义(u=12.210,P=0.011)。治疗4个周期后,试验组疗效及ORR、DCR均优于对照组(P<0.05)。随访3个周期后,对照组KPS为(82.1±1.3)分与试验组的(81.1±1.0)分比较,差异无统计学意义(t=1.588,P=0.214)。结论基于CTCs动态变化个体化治疗SCLC可能会改善SCLC的疗效,且不会带来额外的毒副作用。Objective To investigate the efficacy of intervening in circulating tumor cells（ CTCs） on small cell lung cancer（ SCLC） in aspects of objective response rate（ ORR） and disease control rate（ DCR）. Methods A total of 45 patients with SCLC who were admitted to the First Hospital Affiliated to Shihezi University School of Medicine from January 2012 to June2013,were selected as study subjects,according to random number table method,the patients were divided into control group（ 23 cases） and experiment group（ 22 cases）. For patients in the control group,the therapeutic schedule was adjusted by the imaging findings and serological assessment results（ RECIST）; for patients in the experiment group,the therapeutic schedule was adjusted by CTCs test results. The therapeutic effects and Karnofsky performance score（ KPS） were compared between two groups. Results Among 45 cases with SCLC,CTCs were found in 37 cases,the positive rate was 82%,with 20 cases in the control group（ 87%）,and 17 cases in the experiment group（ 77%）,there was no significant difference in positive rate between two groups（ χ^2= 0. 721,P = 0. 396）. After two cycles of chemotherapy,there were significant differences in efficacy evaluation results between CTCs evaluation method and RECIST evaluation method（ u = 12. 210,P = 0. 011）. After four cycles of chemotherapy,the efficacy,ORR and DCR in experiment group were significantly better than those in control group（ P 〈0. 05）. After three cycles of follow- up,there was no significant difference in KPS between experiment group（ 81. 1 ± 1. 0） and control group（ 82. 1 ± 1. 3）（ t = 1. 588,P = 0. 214）. Conclusion Individualized treatment for SCLC based on dynamic change of CTCs may improve the efficacy,and extra toxic and side effects can be avoided.

关 键 词：癌 小细胞 循环肿瘤细胞 治疗结果 

分 类 号：R169.42[医药卫生—公共卫生与预防医学]