注射用重组改构人肿瘤坏死因子雾化吸入联合吉非替尼治疗EGFR敏感突变的晚期非小细胞肺癌的疗效  

Efficacy of recombinant mutant human tumor necrosis factor aerosol inhalation combined with gefitinib in the treatment of advanced non-small cell lung cancer with EGFR-sensitive mutation

作　　者：吴紫红 宋恩峰[3] WU Zihong;SONG Enfeng(Dept.of Oncology,North-Kuanren General Hospital,Chongqing 401121,China;Dept.of Oncology,The Third People’s Hospital of Hubei Province,Wuhan 430033,Hubei,China;Dept.of Traditional Chinese Medicine,Renmin Hospital of Wuhan University,Wuhan 430060,Hubei,China)

机构地区：[1]重庆北部宽仁医院肿瘤科,重庆401121 [2]湖北省第三人民医院肿瘤科,湖北武汉430033 [3]武汉大学人民医院中医科,湖北武汉430060

出　　处：《武汉大学学报（医学版）》2022年第5期743-747,780,共6页Medical Journal of Wuhan University

摘　　要：目的:观察注射用重组改构人肿瘤坏死因子(rhTNF)雾化吸入联合吉非替尼治疗EGFR敏感突变的晚期非小细胞肺癌(NSCLC)的临床疗效。方法:选取2020年4—10月在湖北省第三人民医院肿瘤科就诊的EGFR敏感突变的晚期NSCLC患者80例,随机分为对照组40例(腺癌35例、鳞癌5例)、治疗组40例(腺癌33例、鳞癌7例)。治疗组给予rhTNF雾化吸入联合吉非替尼靶向治疗,对照组给予单纯吉非替尼治疗,比较两组患者实体瘤客观疗效、呼吸系统症状、肺功能指标、肿瘤标志物、KPS评分及生存期、毒副作用发生情况;同时将所有入组患者按病理类型(腺癌/鳞癌)进行亚组分析,比较各亚组治疗效应的差异性。结果:治疗组实体瘤客观疗效(ORR=50.0%,DCR=92.5%)较对照组(ORR=27.5%,DCR=75.0%)高(P<0.05);两组患者治疗后各项观察指标水平均优于治疗前,且治疗组显著优于对照组(P<0.05);两组患者不良反应总体均较轻微,差异无统计学意义(P>0.05);两种病理类型与干预因素不存在交互效应,疗效具有一致性,无统计学差异(P>0.05),联合治疗相对于单药治疗更为有效(OR=0.225;P<0.05)。结论:rhTNF雾化吸入联合吉非替尼能提高EGFR敏感突变的NSCLC的临床疗效,显著改善呼吸系统症状、肺功能、肿瘤标志物等指标,提高生活质量,一定程度延长生存期,且安全性好,值得临床推广应用。且不同病理类型(腺癌/鳞癌)疗效相同。Objective: To observe the clinical efficacy of recombinant mutant human tumor necrosis factor(rhTNF) aerosol inhalation combined with gefitinib in the treatment of advanced non-small cell lung cancer(NSCLC) with EGFR-sensitive mutation. Methods: A total of 80 advanced NSCLC patients with EGFR-sensitive mutation who were admitted to the Oncology Department of the Third People’s Hospital of Hubei Province from April 2020 to October 2020 were randomly divided into control group(n=40, 35 cases of adenocarcinoma and 5 cases of squamous cell carcinoma) and treatment group(n=40, 33 cases of adenocarcinoma and 7 cases of squamous cell carcinoma). The treatment group was given rhTNF aerosol inhalation combined with gefitinib targeted therapy, and the control group was given gefitinib targeted therapy alone. Objective efficacy of solid tumor was compared between the two groups, KPS score of tumor markers for respiratory symptoms, lung function indicators, and the incidence of toxic and side effects during survival were also evaluated. Then the treatment effect was compared between different pathological subgroups. Results: The objective efficacy of solid tumor in the treatment group(ORR=50. 0%, DCR=92. 5%) was higher than that in the control group(ORR=27. 5%, DCR=75. 0%)(P<0. 05);Overall, adverse reactions in both groups were mild;There was no interaction effect between the two pathological types and the different interventions, the efficacy was consistent(P>0. 05), and combination therapy was more effective than monotherapy(OR=0. 225;P<0. 05). Conclusion: rhTNF aerosol inhalation combined with gefitinib can improve the clinical efficacy of EGFR-sensitive mutation NSCLC, and no difference was found between adenocarcinoma and squamous cell carcinoma. It could improve the patients’ respiratory symptoms, lung function, tumor markers and other indicators, and the quality of life, and prolong the survival period to a certain extent. It is safe and worthy of clinical promotion and application.

关 键 词：重组改构人肿瘤坏死因子 雾化吸入 吉非替尼 晚期非小细胞肺癌 临床疗效 

分 类 号：R734.2[医药卫生—肿瘤]