扶正抗癌方联合吉非替尼治疗EGFR突变阳性晚期非小细胞肺癌的疗效及对血清肿瘤指标的影响  

Efficacy of Fuzheng Anticancer Formula combined with gefitinib in the treatment of advanced non-small cell lung cancer with EGFR sensitive mutation and its effect on serum tumor markers

作　　者：陈贵敏 张乐园 韩平[3] CHEN Gui-min;ZHANG Le-yuan;HAN Ping(Department of Internal Medicine,Linyi Tumor Hospital,Linyi Shandong 276034,China;Department of Emergency,Xianggong Central Health Center,Hedong District,Linyi Shandong 276034,China;Department of Respiratory and Critical Care Medicine,Linyi People's Hospital,Linyi Shandong 276000,China.)

机构地区：[1]临沂市肿瘤医院内科,山东临沂276034 [2]临沂市河东区相公中心卫生院急诊科,山东临沂276034 [3]临沂市人民医院呼吸与危重症医学科,山东临沂276000

出　　处：《临床和实验医学杂志》2022年第2期155-158,共4页Journal of Clinical and Experimental Medicine

基　　金：山东省医学科研基金项目(编号:2018Y080245)。

摘　　要：目的研究扶正抗癌方联合吉非替尼治疗表皮生长因子受体(EGFR)突变阳性晚期非小细胞肺癌(NSCLC)的疗效及对血清肿瘤指标的影响。方法前瞻性选取2017年1月至2019年7月临沂市肿瘤医院收治的126例EGFR突变型晚期NSCLC患者,4例患者在研究过程中失访进行剔除。采用区组随机分为联合治疗组62例,对照组60例,对照组患者治疗药物为吉非替尼,联合治疗组患者治疗药物为扶正抗癌方和吉非替尼,治疗为期10个月并继续随访2年。对比分析两组的临床疗效,治疗前后的中医证候积分,卡式(KPS)评分,血清肿瘤指标[细胞角蛋白19血清片段211(CYFRA21-1)、鳞状上皮细胞癌抗原(SCC)和癌胚抗原(CEA)],无进展生存(PFS)和总生存(OS),不良反应发生情况。结果联合治疗组的客观缓解率为53.23%,显著高于对照组(33.33%),差异有统计学意义(P<0.05)。联合治疗组治疗后的KPS评分为(87.39±4.01)分,显著高于对照组[(82.03±3.85)分],中医证候评分为(31.06±2.89)分,显著低于对照组[(37.84±2.77)分],差异均有统计学意义(P<0.05)。联合治疗组治疗后的血清CEA、CYFRA21-1、SCC水平分别为(51.36±12.68)、(7.16±1.87)、(2.06±1.02)ng/mL,显著低于对照组[(55.21±12.71)、(10.03±2.01)、(2.96±1.15)ng/mL],差异均有统计学意义(P<0.05)。联合治疗组的PFS为9(6,14)个月,相比对照组[6(4,8)个月]明显延长,差异有统计学意义(P<0.05),但OS差异无统计学意义(P>0.05);联合治疗组的不良反应发生率均比对照组低,但差异无统计学意义(P>0.05)。结论扶正抗癌方联合吉非替尼治疗EGFR敏感突变晚期NSCLC能提高抗肿瘤疗效,降低血清肿瘤指标,提高患者生存质量,延长患者生存期,且安全性良好。Objective To study the efficacy of Fuzheng Anticancer Formula combined with gefitinib in the treatment of EGFR sensitive mutant advanced non-small cell lung cancer(NSCLC)and its effect on serum carcinoembryonic antigen(CEA),cytokeratin fragment 19(CYFRA21-1)and squamous cell carcinoma antigen(SCC).Methods A total of 126 patients with EGFR-mutant advanced NSCLC admitted to Linyi Tumor Hospital from January 2017 to July 2019 were prospectively selected,and 4 patients were lost to follow-up during the study and eliminated.They were divided into 62 cases in the combined treatment group and 60 cases in the control group according to the block randomization method.The patients in the control group were treated with gefitinib and the patients in the combination group were treated with Fuzheng Anticancer Formula combined with gefitinib.The treatment duration was 10 months and the follow-up period was 2 years.The clinical effects of the two groups were compared.TCM syndrome score,KPS score,serum tumor markers[cytokeratin 19 serum fragment 211(CYFRA21-1),squamous cell carcinoma antigen(SCC),carcinoembryonic antigen(CEA)]levels before and after treatment,progression-free survival(PFS)and total survival(OS),adverse reactions were also compared.Results The objective response rate of the combined treatment group was 53.23%,which was significantly higher than that of the control group(33.33%),and the difference was statistically significant(P<0.05).After treatment,the scores of KPS in the combination group were(87.39±4.01)socres,which were significantly higher than those in the control group[(82.03±3.85)scores],while the scores of TCM syndrome in the combination group were(31.06±2.89)scores,which were significantly lower than those in the control group[(37.84±2.77)scores],the differences were statistically significant(P<0.05).After treatment,the serum levels of CEA,CYFRA21-1 and SCC in the combination group were(51.36±12.68),(7.16±1.87),(2.06±1.02)ng/mL,respectively,which were significantly lower than those in the contro

关 键 词：非小细胞肺癌 扶正抗癌方 吉非替尼 表皮生长因子受体 肿瘤指标 

分 类 号：R734.2[医药卫生—肿瘤]