吉非替尼靶向治疗对晚期老年非小细胞肺癌患者近远期疗效及凝血功能影响  

Gefitinib targeted therapy on short-term and long-term efficacy and coagulation function in elderly patients with advanced nonsmall cell lung cancer

作　　者：李倩[1] 吕姣[1] 谢晓东[1] 朱梅[1] 邱朝阳 姜海英[1] LI Qian;LYU Jiao;XIE Xiao-dong(Department of Oncology,Xuzhou Tumor Hospital,Xuzhou Jiangsu 221000,China)

机构地区：[1]徐州市肿瘤医院肿瘤内科,江苏徐州221000

出　　处：《临床和实验医学杂志》2021年第23期2523-2527,共5页Journal of Clinical and Experimental Medicine

基　　金：国家科技支撑计划项目(编号:2013BAI06B04H008)。

摘　　要：目的研究吉非替尼靶向治疗对晚期老年非小细胞肺癌(NSCLC)患者近远期疗效及凝血功能影响。方法前瞻性选取2016年4月至2018年4月徐州市肿瘤医院肿瘤内科收治的80例晚期老年非小细胞肺癌患者,按随机数字表法将其分为观察组和对照组,每组各40例。对照组患者均采用传统化疗,观察组口服吉非替尼,且均以21 d为1周期,治疗2周期。统计两组治疗后3个月临床进展情况及不良反应发生率,对比治疗后3个月凝血功能4项[血酶原时间(PT)、部分活化凝血酶原时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)];并对入组患者实施为期3年随访调查,统计无进展生存期、总生存时间。结果观察组客观有效率、疾病控制率分别为32.50%、67.50%,均高于对照组(12.50%、42.50%),差异有统计学意义(P<0.05);两组患者治疗后3个月不良反应均为1/2级,其中观察组皮疹、腹泻发生率为37.50%、35.00%高于对照组(10.00%、15.00%),中性粒细胞降低、白细胞减少、肝功能损伤发生率为2.50%、2.50%、22.50%,均低于对照组(20.00%、22.50%、45.00%),差异均有统计学意义(P<0.05)。观察组治疗后3个月PT、FIB指标为(18.71±1.74)s、(6.88±1.95)g/L,高于对照组[(17.84±1.63)s、(6.02±1.09)g/L],APTT、TT指标为(34.12±5.14)、(15.07±3.01)s,低于对照组[(36.55±5.21)、(16.55±3.19)s],差异均有统计学意义(P<0.05)。治疗结束后随访3年结果显示,观察组无进展生存期、总生存时间均高于对照组,差异均有统计学意义(P<0.05)。结论老年晚期NSCLC患者使用吉非替尼靶向治疗能有效改善其近期疗效和远期预后,但该治疗会导致皮疹发生率变高,且在一定程度加重患者凝血功能异常,使得治疗后静脉血栓风险增高。Objective To study the effects of targeted therapy with gefitinib on the short-and long-term curative effect and coagulation function of elderly patients with advanced non-small cell lung cancer(NSCLC).Methods A total of 80 patients with advanced non-small cell lung cancer admitted to Xuzhou Tumor Hospital from April 2016 to April 2018 were selected and divided into observation group and control group with 40 cases each group according to the random number table method.The patients in the control group were treated with traditional chemotherapy,and the patients in the observation group were given gefitinib orally,and the patients in the observation group were treated with 21 days as 1 cycle and 2 cycles of treatment.The clinical progress and the incidence of adverse reactions 3 months after treatment of the two groups were counted,and 4 items of coagulation function[prothrombin time(PT),partially activated prothrombin time(APTT),thrombin time(TT),fiber Proteinogen(FIB)]levels before and 3 months after treatment were compared;a 3-year follow-up survey was carried out for the enrolled patients,and the progression-free survival and overall survival time were counted.Results The objective effective rate and disease control rate of the observation group were 32.50%and 67.50%,respectively,which were higher than those of the control group(12.50%and 42.50%),the differences were statistically significant(P<0.05).The adverse reactions of the two groups of patients after treatment were both grade 1/2,the incidences of rash and diarrhea in the observation group were 37.50%,35.00%,which were higher than that in the control group(10.00%,15.00%),while the incidence of neutropenia,leukopenia,and liver damage were 2.50%,2.50%,22.50%,which were lower than those in the control group(20.00%,22.50%,45.00%),the differences were statistically significant(P<0.05).Three months after treatment,the PT and FIB indexes of the observation group were(18.71±1.74)s,(6.88±1.95)g/L,which were higher than those of the control group[(17.84±1.63)s

关 键 词：非小细胞肺癌 小分子靶向药物 吉非替尼 凝血功能 临床疗效 

分 类 号：R734.2[医药卫生—肿瘤]