机构地区:[1]邢台市中心医院药剂科,邢台054000 [2]邢台市中心医院急诊科,邢台054000 [3]石家庄市第三医院药剂科,石家庄050000 [4]邢台市中心医院胸外科,邢台054000
出 处:《中国药物应用与监测》2024年第6期783-786,共4页Chinese Journal of Drug Application and Monitoring
基 金:邢台市重点研发计划自筹项目(2023ZC105)。
摘 要:目的分析吉非替尼联合培美曲塞、顺铂靶向治疗表皮生长因子受体(EGFR)突变阳性非小细胞肺癌(NSCLC)患者临床疗效。方法选取2021年1月至2023年1月邢台市中心医院收治的EGFR突变阳性NSCLC患者为研究对象,依照治疗方式的不同分为化疗组139例和靶向治疗组186例。化疗组采用培美曲塞与顺铂治疗,靶向治疗组采用吉非替尼联合培美曲塞、顺铂靶向治疗。比较两组临床疗效,对比治疗前、治疗4个周期后两组肿瘤标志物,统计两组治疗期间不良反应发生率。结果治疗4个周期后,靶向治疗组疾病控制率为89.25%(166/186),高于化疗组的77.70%(108/139),差异有统计学意义(χ^(2)=8.020,P=0.004);靶向治疗组和化疗组癌抗原125(CA125)、癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)水平为[(84.09±16.53)U·mL^(-1)、(38.84±11.47)ng·mL^(-1)、(21.19±4.75)ng·mL^(-1)和(97.88±24.59)U·mL^(-1)、(49.08±15.61)ng·mL^(-1)、(25.85±5.12)ng·mL^(-1)],均低于治疗前[(268.57±36.32)U·mL^(-1)、(126.05±23.77)ng·mL^(-1)、(29.70±5.48)ng·mL^(-1)、和(275.06±43.11)U·mL^(-1)、(121.48±31.01)ng·mL^(-1)、(30.21±6.06)ng·mL^(-1)],且靶向治疗组低于化疗组,差异有统计学意义(P<0.05)。治疗期间,靶向治疗组不良反应发生率低于化疗组,差异有统计学意义(P<0.05)。结论吉非替尼联合培美曲塞、顺铂靶向治疗EGFR突变阳性NSCLC患者临床疗效显著,可降低其肿瘤标志物水平,提高化疗安全性,具有较高临床应用价值。Objective To investigate the clinical efficacy of gefitinib combined with pemetrexed and cisplatin in the treatment of patients with epidermal growth factor receptor(EGFR)mutation-positive non-small cell lung cancer(NSCLC).Methods A total of 325 patients with EGFR mutation-positive NSCLC admitted to Xingtai Central Hospital from January 2021 to January 2023 were selected as the research subjects.According to different treatment methods,they were divided into the chemotherapy group(n=139)and targeted therapy group(n=186).The patients in the chemotherapy group were treated with pemetrexed and cisplatin while those in the targeted therapy group were given gefitinib targeted therapy combined with pemetrexed and cisplatin.The clinical efficacy and tumor markers before treatment and after 4 cycles of treatment were compared between the two groups.The incidence of adverse reactions during treatment were counted in both groups.Results After 4 cycles of treatment,the disease control rate of 89.25%(166/186)in targeted therapy group was higher than that of 77.70%(108/139)in the chemotherapy group(χ^(2)=8.020,P=0.004).The levels of cancer antigen 125(CA125),carcinoembryonic antigen(CEA)and neuron-specific enolase(NSE)in the targeted therapy group and chemotherapy group((84.09±16.53)U·mL^(-1),(38.84±11.47)ng·mL^(-1),(21.19±4.75)ng·mL^(-1),(97.88±24.59)U·mL^(-1),(49.08±15.61)ng·mL^(-1),(25.85±5.12)ng·mL^(-1))were decreased as compared with those before treatment((268.57±36.32)U·mL^(-1),(126.05±23.77)ng·mL^(-1),(29.70±5.48)ng·mL^(-1),(275.06±43.11)U·mL^(-1),(121.48±31.01)ng·mL^(-1),(30.21±6.06)ng·mL^(-1)),and they were lower in the targeted therapy group(P<0.05).The incidence of adverse reactions in the targeted therapy group was significantly lower than that in the chemotherapy group(P<0.05).Conclusion Gefitinib targeted therapy combined with pemetrexed and cisplatin has significant clinical efficacy in the treatment of EGFR mutation-positive NSCLC patients since it can reduce the levels of tumor marke
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