多西他赛联合顺铂二线治疗老年人晚期非小细胞肺癌的有效性和安全性分析  

Effectiveness and safety of docetaxel combined with cisplatin in the second-line treatment of advanced non-small cell lung cancer in older adult patients

作　　者：张居卫 张海英 Zhang Juwei;Zhang Haiying(Department of Pharmacy,Jiaozhou People's Hospital,Jiaozhou 266300,Shandong Province,China;Department of Internal Medicine,Jiulong Hospital of Jiaozhou,Jiaozhou 266300,Shandong Province,China)

机构地区：[1]胶州市人民医院药剂科,胶州266300 [2]胶州市九龙医院内科,胶州266300

出　　处：《中国基层医药》2022年第3期417-422,共6页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨多西他赛联合顺铂二线治疗老年人晚期非小细胞肺癌的有效性和安全性。方法选取胶州市人民医院2017年1月至2019年12月收治的需行二线治疗的老年人晚期非小细胞肺癌120例为观察对象。采用随机数字表法分为观察组和对照组,每组60例。对照组患者接受多西他赛治疗,观察组患者接受多西他赛联合顺铂治疗。比较两组临床疗效及并发症发生情况。结果化疗后,观察组化疗近期总有效率[70.00%(42/60)]高于对照组[33.33%(20/60)],差异有统计学意义(χ^(2)=16.15,P<0.05);观察组血清癌胚抗原(CEA)[(22.57±3.22)μg/L]、糖蛋白抗原125(CA125)[(48.61±5.42)U/mL]、细胞角蛋白19片段抗原21-1(CY211)[(10.61±1.64)μg/L]较对照组[(35.52±4.46)μg/L、(69.64±7.75)U/mL、(14.26±1.95)μg/L]均明显下降,差异均有统计学意义(t=18.23、17.22、11.09,均P<0.001);观察组CD_(3)^(+)[(78.31±8.09)%]、CD_(4)^(+)[(48.63±5.74)%]较对照组[(69.58±7.26)%、(39.82±4.25)%]均明显增高,CD_(8)^(+)[(22.64±3.82)%]较对照组[(26.77±4.01)%]明显下降,差异均有统计学意义(t=-6.22、-9.55、5.77,均P<0.001);观察组1年生存情况显著优于对照组(χ^(2)=4.05,P<0.05);两组化疗期间不良反应发生情况差异均无统计学意义(均P>0.05)。结论多西他赛联合顺铂二线治疗老年人晚期非小细胞肺癌可显著提高疗效,降低机体血清肿瘤标志物水平,增强免疫功能,改善患者1年生存情况,安全可靠,值得临床推广。Objective To investigate the effectiveness and safety of docetaxel combined with cisplatin in the second-line treatment of advanced non-small cell lung cancer in older adult patients.Methods 120 older adult patients with advanced non-small cell lung cancer who received second-line treatment in Jiaozhou People's Hospital from January 2017 to December 2019 were included in this study.They were randomly assigned to undergo treatment with docetaxel(control group,n=60)or docetaxel+cisplatin(observation group,n=60).Clinical efficacy and complications were compared between the two groups.Results After chemotherapy,short-term total response rate was significantly higher in the observation group than in the control group[70.00%(42/60)vs.33.33%(20/60),χ^(2)=16.15,P<0.05].Serum levels of carcinoembryonic antigen,carbohydrate antigen 125,cytokeratin 19-fragment CYFRA21-1 were(22.57±3.22)μg/L,(48.61±5.42)U/mL,(10.61±1.64)μg/L,respectively in the observation group,which were significantly lower than those in the control group[(35.52±4.46)μg/L,(69.64±7.75)U/mL,(14.26±1.95)μg/L,t=18.23,17.22,11.09,all P<0.001].The percentages of CD_(3)^(+)and CD_(4)^(+)cells were(78.31±8.09)%and(48.63±5.74)%,respectively in the observation group,which were significantly higher than those in the control group[(69.58±7.26)%,(39.82±4.25)%,t=-6.22,-9.55,both P<0.001].The percentage of CD_(8)^(+)was significantly lower in the observation group than in the control group[(22.64±3.82)%vs.(26.77±4.01)%,t=5.77,P<0.001].The 1-year survival was significantly higher in the observation group than in the control group(χ^(2)=4.05,P<0.05).There was no significant difference in the incidence of adverse reactions during chemotherapy between the two groups(P>0.05).Conclusion Docetaxel combined with cisplatin is highly effective on advanced non-small cell lung cancer in older adult patients.The combined therapy can decrease serum tumor marker levels,improve immune function,and increase 1-year survival rate.It is safe and provides reliable efficacy

关 键 词：癌 非小细胞肺 抗肿瘤联合化疗方案 肿瘤标记 生物学 免疫调节 生存 安全 药物不良反应 顺铂 紫杉酚 

分 类 号：R734.2[医药卫生—肿瘤]