阿帕替尼联合紫杉醇及顺铂化疗方案用于驱动基因阴性晚期非小细胞肺癌的疗效及相关因素分析  

Analysis of the efficacy and related factors of apatinib combined with paclitaxel and cisplatin chemotherapy regimen for driver-genenegative advanced non-small cell lung cancer

作　　者：孟安娜 李杨[1] 张雯[1] 魏晓为[2] MENG Anna;LI Yang;ZHANG Wen;WEI Xiaowei(Department of Pharmacy,Nanjing First Hospital,Nanjing Medical University(Nanjing First Hospital);Department of Oncology,Nanjing First Hospital,Nanjing Medical University(Nanjing First Hospital),Nanjing,210006,Jiangsu,China)

机构地区：[1]南京医科大学附属南京医院(南京市第一医院)药学部 [2]南京医科大学附属南京医院(南京市第一医院)肿瘤内科,江苏南京210006

出　　处：《大医生》2023年第23期8-11,共4页Doctor

摘　　要：目的 观察阿帕替尼联合紫杉醇及顺铂(TP)化疗方案治疗驱动基因阴性晚期非小细胞肺癌(NSCLC)患者的效果,并分析影响疗效的相关因素,为临床提供参考。方法 选取2020年8月至2021年12月南京医科大学附属南京医院收治的80例驱动基因阴性晚期NSCLC患者为研究对象进行回顾性分析。全部患者均给予阿帕替尼联合TP化疗方案治疗,观察治疗效果,根据治疗效果的不同分为有效组(68例)和无效组(12例),分析影响疗效的独立危险因素。结果 治疗后,6例患者完全缓解,40例患者部分缓解,22例患者疾病稳定,12例患者疾病进展。有效组患者肿瘤分化程度为高分化占比高于无效组,病理分期为Ⅳ期占比低于无效组,癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)、神经元特异性烯醇化酶(NSE)及中性粒细胞与淋巴细胞比值(NLR)水平低于无效组(P<0.05)。多因素Logistic回归分析结果显示,病理分期为Ⅳ期和CEA、CYFRA21-1、NSE、NLR水平升高是影响驱动基因阴性晚期NSCLC患者疗效的独立危险因素(P<0.05),肿瘤分化程度为高分化是驱动基因阴性晚期NSCLC患者疗效的独立保护因素(P<0.05)。结论 阿帕替尼联合TP化疗方案治疗驱动基因阴性晚期NSCLC的效果较好,但受病理分期、肿瘤分化程度和CEA、CYFRA21-1、NSE、NLR水平的影响,临床应加以重视。Objective To observe the effect of apatinib combined with paclitaxel and cisplatin(TP)chemotherapy regimen in the treatment of patients with driver-gene-negative advanced non-small cell lung cancer(NSCLC),and analyze the related factors affecting the efficacy,so as to provide the reference for clinical practice.Methods 80 patients with driver-gene-negative advanced NSCLC who were treated in Nanjing First Hospital,Nanjing Medical University from August 2020 to December 2021 were selected as the research objects for retrospective analysis.All patients were treated with apatinib combined with TP chemotherapy regimen.The therapeutic effect was observed and divided into effective group(68 cases)and ineffective group(12 cases)according to different therapeutic effects,and the independent risk factors affecting the therapeutic effect were analyzed.Results After treatment,6 patients had complete remission,40 patients had partial remission,22 patients had stable disease,and 12 patients had progressive disease.The proportion of highly differentiated tumors in the effective group was higher than that in the ineffective group,the proportion of pathological stageⅣwas lower than that in the ineffective group,and the levels of carcinoembryonic antigen(CEA),cytokeratin 19 fragment(CYFRA21-1),neural specific enolase(NSE),and neutrophil-lymphocyte ratio(NLR)in the effective group were lower than those in the ineffective group(P<0.05).Multivariate Logistic regression analysis showed that the pathological stage ofⅣand the increase levels of CEA,CYFRA21-1,NSE,NLR were independent risk factors for the efficacy of patients with driver-gene-negative advanced NSCLC(P<0.05).The high degree of tumor differentiation was an independent protective factor for the efficacy of patients with driver-gene-negative advanced NSCLC(P<0.05).Conclusion Apatinib combined with TP chemotherapy has good efficacy in the treatment of patients with driver-gene-negative advanced NSCLC,but it should be paid more attention to clinically due to the influ

关 键 词：阿帕替尼 紫杉醇 顺铂 驱动基因阴性 晚期 非小细胞肺癌 

分 类 号：R979.1[医药卫生—药品]