多西他赛、培美曲塞分别联合顺铂对老年晚期非小细胞肺癌患者短期疗效及血清肿瘤标志物影响的比较观察  

Short-term efficacy of docetaxel or pemetrexed combined with cisplatin on elderly patients with advanced non-small cell lung cancer and effects on levels of serum tumor markers

作　　者：张华[1] 贾志阳[1] 高露露 ZHANG Hua;JIA Zhiyang;GAO Lulu(Department of Imaging and Nuclear Medicine,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院影像与核医学科,河南郑州450052

出　　处：《肿瘤基础与临床》2022年第5期380-384,共5页journal of basic and clinical oncology

摘　　要：目的 比较多西他赛、培美曲塞分别联合顺铂对老年晚期非小细胞肺癌患者(NSCLC)患者短期疗效和血清肿瘤标志物的影响。方法 选取郑州大学第一附属医院2017年3月至2020年6月收治的老年晚期NSCLC患者96例,采用随机数字表法分为A组和B组2组,每组48例。2组患者均予以基础治疗,A组同时予以多西他赛联合顺铂,B组同时予以培美曲塞联合顺铂。比较2组患者治疗3后的疗效;记录并比较治疗前和治疗后,2组患者血清肿瘤标志物[血清癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)、糖类抗原125(CA125)]、T淋巴细胞亚群(CD4~+、CD8~+、CD4~+/CD8~+)水平;比较观察2组治疗3后患者不良反应。结果 治疗后,B组治疗总有效率为69.75%,高于A组的46.75%(χ~2=6.095,P=0.014)。经治疗后随访6个月,B组局部控制率、生存率、疾病无进展生存时间分别为89.58%、93.75%、(5.47±0.16)个月,均高于A组[72.92%,77.80%,(5.01±0.29)个月;χ~2=4.376,P=0.036;χ~2=5.352,P=0.021;t=9.622,P<0.001]。治疗前较治疗3后,A组和B组患者血清肿瘤标志物(CEA、CYFRA21-1、CA125)水平、CD8~+水平均有下降(A组:t=52.849,P<0.001;t=27.427,P<0.001;t=77.184,P<0.001;t=3.615,P<0.001;B组:t=51.758,P<0.001;t=31.057,P<0.001;t=79.443,P<0.001;t=5.937,P<0.001),且B组低于A组(t=5.796,P<0.001;t=3.404,P<0.001;t=7.486,P<0.001;t=2.518,P<0.001);治疗3后较治疗前,2组患者CD4~+、CD4~+/CD8~+水平均有升高(A组:t=4.649,P<0.001;t=8.660,P<0.001;B组:t=8.814,P<0.001;t=13.600,P<0.001),且B组高于A组(t=3.261,P<0.001;t=3.651,P<0.001)。治疗3内,B组患者不良反应总发生率为12.50%,低于A组的31.25%(χ~2=4.937,P=0.026)。结论 培美曲塞联合顺铂对老年晚期NSCLC患者预后改善优于多西他赛联合顺铂,具有临床使用价值。Objective To compare the effects of docetaxel or pemetrexed combined with cisplatin on the short-term prognosis of elderly patients with advanced non-small cell lung cancer(NSCLC) and serum tumor markers. Methods All the 96 elderly patients with advanced NSCLC who were treated in the First Affiliated Hospital of Zhengzhou University from Mar 2017 to Jun 2020 were selected and divided into the group A and the group B by the random number table method, with 48 patients in each group. Both groups were given basic treatment, and the group A was given docetaxel combined with cisplatin, and the group B was given pemetrexed combined with cisplatin. The treatment effect after 3 months of treatment was compared between the two groups. The serum levels of tumor markers [serum carcinoembryonic antigen(CEA), cytokeratin 19 fragment(CYFRA21-1), carbohydrate antigen 125(CA125)] and T lymphocyte subsets(CD4, CD8, CD4/CD8) were recorded before treatment and after 3 months of treatment. Adverse reactions of the two groups were compared within 3 courses of treatment. Results After 3 months of treatment, the total effective rate of treatment in the group B(69.75%) was higher than that in the group A(46.75%;χ~2=6.095,P=0.014). At 6 months of follow-up after treatment, the local control rate, survival rate, progression-free survival time of the group B [89.58%, 93.75%,(5.47±0.16)months] were higher or longer than those of group A [72.92%, 77.80%,(5.01±0.29)months;χ~2=4.376,P=0.036;χ~2=5.352,P=0.021;t=9.622,P<0.001]. After 3 months of treatment, the levels of serum tumor markers(CEA, CYFRA21-1, CA125) and T lymphocyte subset(CD8) of patients in the two groups were decreased compared with those before treatment(group A:t=52.849,P<0.001;t=27.427,P<0.001;t=77.184,P<0.001;t=3.615,P<0.001;group B:t=51.758,P<0.001;t=31.057,P<0.001;t=79.443,P<0.001;t=5.937,P<0.001), and the levels of the group B were lower compared to the group A(t=5.796,P<0.001;t=3.404,P<0.001;t=7.486,P<0.001;t=2.518,P<0.001). The levels of some T lymphocyte subsets(CD

关 键 词：多西他赛 培美曲塞 顺铂 非小细胞肺癌 

分 类 号：R734.2[医药卫生—肿瘤]