吉非替尼联合培美曲塞与顺铂治疗晚期非小细胞肺癌的疗效观察  

Efficacy of gefitinib combined with pemetrexed and cisplatin for advanced non-small cell lung cancer

作　　者：常永莉[1] 张莉媛 王惠琴 王冰[1] 陈方园 李天浩[1] CHANG Yong-li;ZHANG Li-yuan;WANG Hui-qin;WANG bing;CHEN Fang-yuan;LI Tian-hao(Department of Respiratory and Critical Care Medicine,The Second Affiliated Hospital of Shaanxi Universi-ty of Traditional Chinese Medicine,Xianyang 712000,China)

机构地区：[1]陕西中医药大学第二附属医院呼吸与危重症医学科,咸阳712000

出　　处：《中国肿瘤临床与康复》2022年第2期129-133,共5页Chinese Journal of Clinical Oncology and Rehabilitation

基　　金：陕西中医药大学第二附属医院学科创新团队(2020XKTD-C04)。

摘　　要：目的探讨吉非替尼联合培美曲塞与顺铂治疗晚期非小细胞肺癌(NSCLC)的近期疗效及对血清肿瘤标志物及免疫功能的影响。方法选取2016年4月至2018年4月间陕西中医药大学第二附属医院收治的84例晚期NSCLC患者,根据治疗方式不同分为联合组46例和对照组38例。对照组患者采用培美曲塞与顺铂治疗,联合组患者在此基础上联合吉非替尼治疗,比较两组患者的近期疗效、血清肿瘤标志物、细胞因子、免疫功能及不良反应。结果联合组患者客观缓解率和疾病控制率均高于对照组,差异均有统计学意义(均P<0.05)。治疗后,两组患者血清肿瘤标志物水平均下降,且联合组水平均低于对照组,差异均有统计学意义(均P<0.05)。治疗后,联合组患者肿瘤坏死因子和γ干扰素水平均高于对照组,白介素-10水平低于对照组,差异均有统计学意义(均P<0.05)。治疗后,联合组患者CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+)均高于对照组,差异均有统计学意义(均P<0.05);两组患者CD8^(+)水平比较,差异无统计学意义(P>0.05)。联合组患者不良反应发生率为17.4%,低于对照组的44.7%,差异有统计学意义(P<0.05)。结论吉非替尼联合培美曲塞与顺铂治疗晚期NSCLC患者,可有效提高患者的近期疗效,改善免疫功能,降低血清肿瘤标志物水平,不良反应相对较少,有较高的安全性。Objective To observe the short-term efficacy of gefitinib combined with pemetrexed and cisplatin in the treatment of advanced non-small cell lung cancer(NSCLC),and analyze the effect on serum tumor markers and immune function.Methods A total of 84 patients with advanced NSCLC admit-ted to The Second Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine were selected from April 2016 to April 2018.According to the differences in treatment methods,patients were categorized into a combination group(46 patients)and a control group(38 patients).Gefitinib combined with peme-trexed and cisplatin were administered in the combination group and pemetrexed and cisplatin were adminis-tered in the control group.The short-term efficacy,serum tumor markers,cytokines,immune function and adverse reactions were compared between the two groups.Results The objective remission rate(ORR)and disease control rate(DCR)were higher in the combination group than in the control group(all P<0.05).The serum tumor markers decreased in both groups with the levels lower in the combination group than in the control group(all P<0.05).After the treatment,the serum levels of tumor necrosis factor-α(TNF-α)and interferon-γ(IFN-γ)were significantly higher in the combination group than in the control group,and the levels of interleukin-10(IL-10)were significantly lower in the combination group than in the control group(all P<0.05).The immune function indicators of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)were sig-nificantly higher in the combination group than in the control group(P<0.05).The incidence of adverse reactions was 17.4%in the combination group which was significantly lower than 44.7%of the control group(P<0.05).Conclusion Gefitinib combined with pemetrexed and cisplatin can effectively improve the short-term efficacy and the immune function and down-regulate the level of serum tumor markers in pa-tients with advanced NSCLC with few adverse reaction and high safety.

关 键 词：吉非替尼 培美曲塞 顺铂 晚期 癌 非小细胞肺 肿瘤标志物 免疫功能 

分 类 号：R734.2[医药卫生—肿瘤]