厄洛替尼联合白蛋白紫杉醇与卡铂治疗NSCLC患者的疗效及安全性分析  

Efficacy and safety of erlotinib combined with albumin-bound paclitaxel and carboplatin in the treatment of NSCLC patients

作　　者：白爽 罗国强 张晶 BAI Shuang;LUO Guoqiang;ZHANG Jing(Hematologic Tumor Center,Xi'an People's Hospital&Xi'an Fourth Hospital,Xi'an 710004,Shaanxi,China;Department of Neurosurgery,The Second Affiliated Hospital of Air Force Medical University&Tangdu Hospital of Air Force Medical University,Xi'an 710038,Shaanxi,China;Department of Oncology,The First Affiliated Hospital of Air Force Medical University&Xijing Hospital of Air Force Medical University,Xi'an 710032,Shaanxi,China)

机构地区：[1]西安市人民医院暨西安市第四医院血液肿瘤中心,陕西西安710004 [2]空军军医大学第二附属医院暨空军军医大学唐都医院神经外科,陕西西安710038 [3]空军军医大学第一附属医院暨空军军医大学西京医院肿瘤科,陕西西安710032

出　　处：《中国肿瘤生物治疗杂志》2024年第12期1235-1241,共7页Chinese Journal of Cancer Biotherapy

摘　　要：目的:评价厄洛替尼联合白蛋白紫杉醇与卡铂治疗EGFR驱动基因阳性NSCLC患者的临床疗效及安全性。方法:选取2019年5月至2021年6月于西京医院肿瘤科接受治疗的80例EGFR驱动基因阳性NSCLC患者作为研究对象,按照治疗方法分为研究组(n=38)及对照组(n=42),两组患者均予厄洛替尼靶向治疗,研究组患者同时联合白蛋白紫杉醇与卡铂化疗。比较两组患者的治疗疗效(客观缓解率、疾病控制率)、免疫功能[CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)、自然杀伤(NK)细胞]、生存状况[3年生存率、总生存期(OS)和无进展生存期(PFS)、卡氏功能状态(KPS)评分]、肿瘤标志物水平[癌胚抗原(CEA)、细胞角蛋白片段19(CYFRA21-1)、血管内皮生长因子(VEGF)]及不良反应发生率。结果:研究组疾病控制率为89.47%,高于对照组的42.86%,差异有统计学意义(P <0.05);研究组客观缓解率为36.84%高于对照组的23.81%,但差异无统计学意义(P> 0.05)。治疗后,研究组CD3^(+)、CD4^(+)、NK细胞、CD4^(+)/CD8^(+)水平均高于对照组,而CD8^(+)水平低于对照组(均P <0.05);两组3年生存率差异无统计学意义(P> 0.05);研究组OS、PFS均长于对照组(均P <0.05),且KPS评分高于对照组(P <0.05);研究组的CEA、CYFRA21-1、VEGF水平均低于对照组(均P <0.05);研究组骨髓抑制发生率高于对照组(均P <0.05)。结论:厄洛替尼靶向联合白蛋白紫杉醇与卡铂治疗EGFR驱动基因阳性NSCLC,治疗效果良好,可减少免疫功能损伤,延长晚期NSCLC患者PFS,提升其生活质量,且安全性良好。Objective:To evaluate the clinical efficacy and safety of erlotinib combined with albumin-bound paclitaxel and carboplatin in the treatment of patients with EGFR-mutation positive non-small cell lung cancer(NSCLC).Methods:A total of 80 patients with EGFR-mutation positive NSCLC treated at the Department of Oncology,Xijing Hospital from May 2019 to June 2021 were retrospectively selected for this study.According to their treatment methods,the patients were divided into two groups:the study group(n=38)and the control group(n=42).Both groups received erlotinib targeted therapy,while the study group also received combination chemotherapy with albumin-bound paclitaxel and carboplatin.The treatment efficacy[objective response rate(ORR),disease control rate(DCR)],immune function[CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+),natural killer(NK)cells],survival status[3-years survival rate,overall survival(OS),progression-free survival(PFS),Karnofsky performance status(KPS)score],levels of tumor markers[carcinoembryonic antigen(CEA),cytokeratin fragment 19(CYFRA21-1),vascular endothelial growth factor(VEGF)],and the incidence of adverse reactions were compared between the two groups.Results:The DCR in the study group was significantly higher than that in control group(89.47%vs 42.86%)(P<0.05).The ORR in the study group was also higher than that in control group(36.84%vs 23.81%),but the difference was not statistically significant(P>0.05).After treatment,the study group showed significantly higher levels of CD3^(+),CD4^(+),NK cells and CD4^(+)/CD8^(+)ratio,and lower levels of CD8^(+)compared to the control group(all P<0.05).There was no significant difference in 3-years survival rate between the two groups(P>0.05).However,the OS and PFS of the study group were longer than those of the control group(both P<0.05),and the KPS score was higher(P<0.05).The levels of CEA,CYFRA21-1 and VEGF in the study group were lower than those in control group(P<0.05).The incidence of bone marrow suppression was higher in the study group than in cont

关 键 词：非小细胞肺癌 免疫功能 无进展生存期 厄洛替尼 白蛋白紫杉醇 

分 类 号：R734.2[医药卫生—肿瘤] R730.53[医药卫生—临床医学] R969.4