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作 者:朱娜[1] 胡鑫[1] 杨春燕[1] ZHU Na;HU Xin;YANG Chun-yan(Department of Respiratory Medicine,Lushan Rehabilitation Center,Joint Logistics Support Force of the PLA,Jiujiang 332000,China)
机构地区:[1]中国人民解放军联勤保障部队庐山康复疗养中心呼吸内科,江西九江332000
出 处:《南昌大学学报(医学版)》2022年第1期56-60,共5页Journal of Nanchang University:Medical Sciences
摘 要:目的探讨阿帕替尼辅助多西他赛联合顺铂(DP)方案治疗晚期非小细胞肺癌患者的疗效及对血清人类阳离子抗菌蛋白18(hCAP18)及Pokemon表达的影响。方法将114例晚期非小细胞肺癌患者,根据随机数字表法分为对照组和观察组,每组各57例。对照组给予DP方案,观察组给予阿帕替尼辅助DP方案,21 d为1个疗程,随访2年。对比2组治疗前后的临床疗效和血肿瘤标志物(CYFRA21-1、VEGF以及CEA)水平、血清hCAP18和Pokemon水平、生存情况和不良反应(心脏毒性、血小板减少、肝肾功能损害、白细胞减少和胃肠道反应)。结果观察组的客观缓解率(ORR)(70.18%)和疾病控制率(DCR)(92.98%)明显高于对照组(ORR:50.88%,DCR:77.19%),差异有统计学意义(均P<0.05)。治疗后2组肿瘤标志物水平和血清hCAP18和Pokemon水平均较治疗前降低,且观察组较对照组降低更明显(均P<0.05)。观察组的平均生存期[(11.19±2.57)年比(9.48±2.12)年]和1年生存率(54.39%比35.09%)均明显高于对照组(均P<0.05)。2组的各种不良反应发生率比较差异均无统计学意义(均P>0.05)。结论阿帕替尼联合DP治疗可能发生协同作用,增强抗肿瘤效果,可有效改善患者的临床疗效,提高患者的生存率,且未增加不良反应发生率。Objective To explore the efficacy of apatinib-assisted docetaxel-cisplatin(DP)regimen in the treatment of advanced non-small cell lung cancer(NSCLC)and its effect on rerum human cathelicidin antimicrobial protein 18(hCAP18)and pokemon expression.Methods A total of 114 patients with advanced NSCLC were randomly treated with either DP regimen(control group,n=57)or apatinib-assisted DP regimen(observation group,n=57).A course of treatment was 21 days.Patients were followed up for 2 years.Clinical efficacy,tumor markers(CYFRA21-1,VEGF and CEA),serum hCAP18 and Pokemon levels,survival rate,and adverse reactions(cardiotoxicity,thrombocytopenia,hepatorenal impairment,leukopenia and gastrointestinal reactions)were compared between the two groups.Results The objective response rate(ORR)and disease control rate(DCR)in the observation group(70.18%and 92.98%,respectively)were respectively higher than those in the control group(50.88%and 77.19%,respectively)(P<0.05).After treatment,the levels of CYFRA21-1,VEGF,CEA,hCAP18 and Pokemon decreased in both groups,and the decrease in the observation group was more significant than that in the control group(P<0.05).Compared with the control group,the mean survival time and 1-year survival rate were significantly increased in the observation group((11.19±2.57)years vs(9.48±2.12)years and 54.39%vs 35.09%,respectively;P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Apatinib and DP have a synergistic effect to enhance the anti-tumor activity.The combined treatment can effectively improve the clinical efficacy,increase the survival rate,and does not increase the incidence of adverse reactions in patients with advanced NSCLC.
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