白蛋白结合型紫杉醇联合顺铂治疗晚期非小细胞肺癌的近期疗效及安全性  

Short-term efficacy and safety of albumin-bound paclitaxel combined with cisplatin on treating advanced non-small cell lung cancer

作　　者：罗世程 肖冬平[1] 黄秀玲 左炜 胡向东[1] 邓志辉 LUO Shicheng;XIAO Dongping;HUANG Xiuling;ZUO Wei;HU Xiangdong;DENG Zhihui(Department of Respiratory Medicine,the First Hospital of Nanchang,Nanchang 330006,China)

机构地区：[1]南昌市第一医院呼吸内科,330006

出　　处：《临床合理用药杂志》2023年第27期12-15,19,共5页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的观察白蛋白结合型紫杉醇联合顺铂治疗晚期非小细胞肺癌(NSCLC)的近期疗效及安全性。方法选取2020年10月-2022年9月南昌市第一医院收治的66例晚期NSCLC患者,以随机数字表法分为对照组(n=33)和研究组(n=33)。对照组患者采用吉西他滨联合顺铂治疗,研究组患者采用白蛋白结合型紫杉醇联合顺铂治疗,2组患者均以21 d为1个疗程,持续治疗3个疗程。比较2组近期疗效,治疗前及治疗3个疗程后血清肿瘤标志物[细胞角蛋白19片段抗原21-1(CYFRA21-1)、糖类抗原125(CA125)、癌胚抗原(CEA)]、T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))及严重不良反应发生率。结果研究组客观缓解率、疾病控制率分别为60.61%、78.79%,分别高于对照组的36.36%、51.52%(χ^(2)/P=3.882/0.049、5.405/0.020)。治疗3个疗程后,2组血清CYFRA21-1、CA125、CEA水平较治疗前降低,且研究组较对照组更低(P<0.01);2组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)较治疗前升高,CD8^(+)较治疗前降低,且研究组升高/降低幅度大于对照组(P<0.05或P<0.01)。研究组Ⅲ~Ⅳ度不良反应总发生率低于对照组(12.12%vs.36.36%,χ^(2)=5.280,P=0.022)。结论白蛋白结合型紫杉醇联合顺铂治疗晚期NSCLC患者可提高近期疗效,其可有效提高患者的免疫功能,抑制病情进展,且具有较高安全性。Objective To explore the short-term efficacy and safety of albumin-bound paclitaxel combined with cisplatin on treating advanced NSCLC.Methods A total of 66 patients with advanced NSCLC were selected in the First Hospital of Nanchang from October 2020 to September 2022,and they were divided into the control group(33 cases)and the study group(33 cases).The control group was treated with gemcitabine combined with cisplatin,while the study group was treated with albumin-bound paclitaxel combined with cisplatin,patients of the two groups were taken 21 days as a course of treatment,and continued to treat for 3 courses.Short-term efficacy,serum tumor markers(CYFRA21-1,CA125,CEA),T lymphocyte subsets(CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+))before and after 3 courses of treatment,and incidence of serious adverse reactions were compared between the two groups.Results Objective relief rate,disease control rate of the study group was 60.61%,78.79%,which was higher than 36.36%,51.52%,respectively(χ^(2)/P=3.882/0.049,5.405/0.020).After 3 courses of treatment,serum levels of CYFRA21-1,CA125,CEA of the two groups were lower than those before treatment,and the study group were lower than those of the control group(P<0.01);CD3^(+),CD4^(+),CD4^(+)/CD8^(+)of the two groups were higher than those before treatment,CD8^(+)was lower than that before treatment,and increased/decreased range of indexes of the study group were larger than those of the control group(P<0.05 or P<0.01).Incidence ofⅢ-Ⅳadverse reactions in the study group was lower than that of the control group(12.12%vs.36.36%,χ^(2)=5.280,P=0.022).Conclusion Albumin-bound paclitaxel combined with cisplatin can promote short-term curative effect of patients with advanced NSCLC,it can effectively promote immune function of patients,inhibit disease progression,and with higher safety.

关 键 词：非小细胞肺癌 晚期 白蛋白结合型紫杉醇 顺铂 近期疗效 安全性 

分 类 号：R734.2[医药卫生—肿瘤]