EGFR TKI+TP方案及TP方案对晚期非小细胞肺癌治疗临床效果及肿瘤标志物水平的影响  

Efficacy and Prognosis Research on EGFR TKI+TP and TP Regimens for Advanced Non-Small Cell Lung Cancer and Impact on Tumor Marker Levels

作　　者：梁秋萍[1] 殷俊[1] 

机构地区：[1]成都市第三人民医院呼吸内科,成都610000

出　　处：《成都医学院学报》2016年第1期40-44,共5页Journal of Chengdu Medical College

基　　金：四川省卫生厅课题(No:120535)

摘　　要：目的探究EGFR TKI+TP方案(厄洛替尼联合紫杉醇、顺铂化疗方案)及TP方案(紫杉醇、顺铂化疗方案)对晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)治疗临床效果及肿瘤标志物水平的影响。方法分析2012年1月至2013年12月在成都市第三人民医院呼吸内科接受治疗的84例晚期NSCLC患者的临床资料,观察组(n=43)给予EGFR TKI+TP方案治疗,对照组(n=41)给予TP方案治疗。观察比较两组临床化疗效果、肿瘤标志物表达情况及生存率。结果两组治疗后血清CEA、CA125及Cyfra21-1水平与治疗前相比明显降低,差异有统计学意义(P=0.002,0.001,0.045);对照组治疗后血清CEA、CA125及Cyfra21-1水平明显高于观察组,差异有统计学意义(P=0.022,0.031,0.036);观察组治疗有效率为81.40%,对照组治疗有效率为48.78%,采用Wilcoxon秩和检验法进行分析,观察组治疗有效率明显高于对照组,差异有统计学意义(Z=3.520,P<0.001);观察组PR、SD、PD患者血清中,CEA、CA125及Cyfra21-1水平明显低于对照组,差异有统计学意义[P=(0.026,0.021,0.014)vs(0.037,0.042,0.029)vs(0.007,0.011,0.018)];观察组不良反应发生率明显低于对照组,差异有统计学意义(P=0.042);通过Kaplan-Meier生存分析发现,观察组患者生存率明显高于对照组,差异有统计学意义(5/43,11.63%vs14/41,34.15%;Log-rank2=7.912,P=0.005)。结论 EGFR TKI+TP方案化疗联合使用,可明显改善晚期NSCLC的治疗效果,不良反应小,有助于提高患者生存率,有效降低患者血清中肿瘤标志物的浓度,临床上可用于晚期NSCLC表皮生长因子(EGFR)基因突变患者的治疗。Objective To investigate the clinical effect and prognosis of for the patients with advanced non small cell lung cancer by different chemotherapy regimens and its impact on the levels of tumor markers.Methods The clinical data of 84 patients with advanced non-small cell lung cancer（NSCLC）for treatment in our hospital from January 2012 to December 2013 were analyzed and divided into observation group（n=43）given erlotinib,paclitaxel and cisplatin for treatment,and control group（n=41）given paclitaxel and cisplatin for treatment.The clinical curative effect,the expression of tumor markers and survival rate in two groups were compared.Results After treatment,the levels of serum CEA,CA125 and Cyfra21-1 were significantly decreased in the two groups,the differences were statistically significant（P=0.002,0.001,0.045）.After treatment,serum CEA,CA125 and Cyfra21-1level in control group were significantly higher than those of the observation group,the difference had statistical significance（P=0.022,0.031,0.036）;In observation group,the treatment effective rate was 81.40%;in control group,the effective rate of the treatment was 48.78%.According to the analysis of Wilcoxon test method,the efficacy in observation group was significantly higher than that of control group,the difference was statistically significant（Z=3.520,P〈0.001）.CEA,CA125 and Cyfra21-1levels in PR,SD and PD patients in observation group were significantly lower than those in control group,the differences of which were statistically significant[P=（0.026,0.021,0.014）VS（0.037,0.042,0.029）VS（0.007,0.011,0.018）].The adverse reactions incidence in observation group were significantly lower than those of control group,the differences were statistically significant（P =0.042）.According to the Kaplan Meier survival analysis,the survival rate in observation group was significantly higher than that of the control group,the difference was statistically significant（5/43,11.63%vs 14/41,34.15%;Log-rank2=7.912,P=0.005）.Conclus

关 键 词：非小细胞肺癌 表皮生长因子 酪氨酸激酶抑制剂 厄洛替尼 紫杉醇 顺铂 

分 类 号：R734.2[医药卫生—肿瘤]