肺癌合剂联合吉非替尼治疗EGFR敏感突变的非小细胞肺癌的疗效及安全性评价

目的研究肺癌合剂联合吉非替尼治疗表皮生长因子受体(EGFR)敏感突变的非小细胞肺癌的疗效及安全性。方法回顾性选取2018年1月至2020年1月武汉市第一医院收治的80例EGFR敏感突变的非小细胞肺癌患者为研究对象,根据不同用药方式分为研究组(n=40)与对照组(n=40)。对照组单用吉非替尼治疗,研究组联用吉非替尼与肺癌合剂治疗。比较2组治疗前、治疗4周后T淋巴细胞亚群(CD3⁺、CD4⁺、CD8⁺、CD4⁺/CD8⁺)含量、血清肿瘤标志物(神经元特异性烯醇化酶、癌胚抗原、血清癌抗原125、血清细胞角蛋白19片段)水平以及治疗总有效率、不良反应发生率(恶心呕吐、贫血、高血压、皮疹、手足综合征)。结果治疗4周后,2组患者CD3⁺、CD4⁺、CD4⁺/CD8⁺水平较治疗前更高,CD8⁺含量与血清神经元特异性烯醇化酶、癌胚抗原、血清癌抗原125、血清细胞角蛋白19片段水平较治疗前更低,差异均有统计学意义(P<0.05);治疗4周后,研究组CD3⁺、CD4⁺、CD4⁺/CD8⁺含量(63.08±5.23)%、(37.52±4.26)%、1.32±0.25]较对照组(30.03±3.56)%、(37.52±4.26)%、0.84±0.22]更高,CD8⁺含量与血清神经元特异性烯醇化酶、癌胚抗原、血清癌抗原125、血清细胞角蛋白19片段水平(53.42±4.38)%、(16.12±3.93)ng/mL、(30.24±4.38)ng/mL、(50.23±6.48)U/mL、(6.52±3.09)ng/mL]较对照组(33.28±4.76)%、(21.06±3.86)ng/mL、(59.81±5.18)ng/mL、(78.69±6.76)U/mL、(10.86±3.14)ng/mL]更低,差异均有统计学意义(P<0.05)。研究组总有效率(87.50%)明显高于对照组(65.00%),差异有统计学意义(P<0.05)。研究组不良反应发生率(10.00%)与对照组(12.50%)比较,差异无统计学意义(P>0.05)。结论肺癌合剂联合吉非替尼治疗EGFR敏感突变的非小细胞肺癌的疗效显著,可提升患者免疫功能与改善肿瘤标志物水平,且不良反应少,安全性高。

Efficacy and safety of lung cancer mixture combined with gefeitinib in the treatment of EGFR-sensitive non-small cell lung cancer

Objective To study the efficacy and safety of lung cancer combination therapy with gefitinib in the treatment of sensitive non-small cell lung cancer with epidermal growth factor receptor(EGFR).Methods From January 2018 to January 2020,80 cases of non-small cell lung cancer patients with EGFR-sensitive mutations admitted to Wuhan First Hospital were retrospectively selected as the research objects,and divided into study group(n=40)and control group(n=40)according to different medication methods.The control group was treated with gefitinib alone,while the study group was treated with gefitinib combined with lung cancer mixture.Comparing the two groups before and after 4 weeks of treatment of T lymphocyte subsets(CD3⁺,CD4⁺,CD8⁺,CD4⁺/CD8⁺),serum tumor markers(neuron specificity enolization enzyme,carcinoembryonic antigen,cancer antigen 125,cytokeratin 19 fragment)level and the total effective rate,incidence of adverse reactions(nausea and vomiting syndrome),anemia,hypertension,skin rashes,hands and feet.Results After 4 weeks of treatment,the content of CD3⁺,CD4⁺,CD4⁺/CD8⁺in the two groups were higher than before treatment,the content of CD8⁺and serum neuron-specific enolase,carcinoembryonic antigen,cancer antigen 125,and cytokeratin 19 Fragment were lower than before treatment,and the differences were statistically significant(P<0.05);after 4 weeks of treatment,the content of CD3⁺,CD4⁺,CD4⁺/CD8⁺in study group(63.08±5.23)%,(37.52±4.26)%,1.32±0.25]were higher than those in the control group(30.03±3.56)%,(37.52±4.26)%、0.84±0.22],the content of CD8⁺and the levels of serum neuron-specific enolase,carcinoembryonic antigen,cancer antigen 125,and cytokeratin 19 fragment(53.42±4.38)%,(16.12±3.93)ng/mL,(30.24±4.38)ng/mL,(50.23±6.48)U/mL,(6.52±3.09)ng/mL]were lower than those in the control group(33.28±4.76)%,(21.06±3.86)ng/mL,(59.81±5.18)ng/mL,(78.69±6.76)U/mL,(10.86±3.14)ng/mL],and the differences were statistically significant(P<0.05).The total effective rate of the study group(87.50%)was significantly higher than that of the control group(65.00%),and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the study group(10.00%)and the control group(12.50%)(P>0.05).Conclusion Lung cancer mixture combined with gefeitinib in the treatment of EGFR-sensitive non-small cell lung cancer has a significant effect,can improve the immune function of patients and improve the level of tumor markers,with fewer adverse reactions,high safety.