不同化疗方案治疗晚期肺癌合并肺结核对血液系统毒性的回顾性分析
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摘要
目的探讨抗癌化疗与抗结核化疗联合应用是否加重血液系统毒性,分析其安全性以及探讨治疗方案的选择。方法 2017年1月—12月,医院收治Ⅳ期肺癌抗癌化疗患者(抗癌化疗组) 67例,Ⅳ期肺癌合并肺结核行抗癌化疗联合抗结核化疗(联合治疗组)患者20名。利用SPSS 22. 0软件进行统计分析,比较两组的血液系统毒性,并对年龄、抗癌化疗方案进行分层分析。结果联合治疗组总体血液系统毒性的程度略高于抗癌化疗组,平均秩次为48. 32和42. 71,但P> 0. 05,没有统计学意义。年龄分层后,两个治疗组的血液系统毒性差异仍然没有统计学意义。在4种抗癌化疗方案中,只有GP方案(吉西他滨+顺铂)两组的差异最明显,P值为0. 053,没有统计学意义。结论抗癌化疗与抗结核化疗联合治疗不会加重晚期肺癌合并肺结核患者的血液系统毒性。且血液系统毒性与年龄和抗癌化疗方案没有显著相关性。
Objective The morbidity of lung cancer concomitant with pulmonary tuberculosis is increasing. Anti-cancer chemotherapy is the recommended option for many patients with lung cancer,while anti-tuberculosis chemotherapy for pulmonary tuberculosis. Hematologic toxicity is one of the common side-effect induced by anti-cancer chemotherapy and anti-tuberculosis chemotherapy. This study investigated the safety of anti-cancer chemotherapy combined with anti-tuberculosis chemotherapy by hematologic toxicity,and explored the better chemotherapy regimen. Methods During 2017,there were 67 patients diagnosed stage Ⅳ lung cancer treated with anti-cancer chemotherapy( anti-cancer chemo group)and 20 diagnosed stage Ⅳ lung cancer complicated by pulmonary tuberculosis treated with anti-cancer chemotherapy combined with anti-tuberculosis chemotherapy( combination group) were enrolled in our hospital. The hematologic toxicity was compared between two group. And the data was further analyzed after stratified by age and anti-cancer chemotherapy regimen. All analyses were performed with SPSS22. 0 software. Results The average sum of ranks of hematologic toxicity was48. 32 in the combination group and 42. 71 in the anti-cancer chemo group,P > 0. 05,with no statistically significant between the two groups. After age stratified,analysis also showed no significant results. Among four anti-cancer chemotherapy regimens,Gemcitabine plus platinum( GP group) showed maximum differences,but P = 0. 053,with no statistically significant. Conclusion The study shows that combination treatment are possibly not enhance hematologic toxicity in patients diagnosed stage Ⅳ lung cancer complicated by pulmonary tuberculosis. Moreover,there is no significant correlation between hematologic toxicity and age and anti-cancer chemotherapy regimens.
Objective The morbidity of lung cancer concomitant with pulmonary tuberculosis is increasing. Anti-cancer chemotherapy is the recommended option for many patients with lung cancer,while anti-tuberculosis chemotherapy for pulmonary tuberculosis. Hematologic toxicity is one of the common side-effect induced by anti-cancer chemotherapy and anti-tuberculosis chemotherapy. This study investigated the safety of anti-cancer chemotherapy combined with anti-tuberculosis chemotherapy by hematologic toxicity,and explored the better chemotherapy regimen. Methods During 2017,there were 67 patients diagnosed stage Ⅳ lung cancer treated with anti-cancer chemotherapy( anti-cancer chemo group)and 20 diagnosed stage Ⅳ lung cancer complicated by pulmonary tuberculosis treated with anti-cancer chemotherapy combined with anti-tuberculosis chemotherapy( combination group) were enrolled in our hospital. The hematologic toxicity was compared between two group. And the data was further analyzed after stratified by age and anti-cancer chemotherapy regimen. All analyses were performed with SPSS22. 0 software. Results The average sum of ranks of hematologic toxicity was48. 32 in the combination group and 42. 71 in the anti-cancer chemo group,P > 0. 05,with no statistically significant between the two groups. After age stratified,analysis also showed no significant results. Among four anti-cancer chemotherapy regimens,Gemcitabine plus platinum( GP group) showed maximum differences,but P = 0. 053,with no statistically significant. Conclusion The study shows that combination treatment are possibly not enhance hematologic toxicity in patients diagnosed stage Ⅳ lung cancer complicated by pulmonary tuberculosis. Moreover,there is no significant correlation between hematologic toxicity and age and anti-cancer chemotherapy regimens.
引文
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[9]王月,金建华,陆文斌,等.培美曲塞联合顺铂治疗中晚期非小细胞肺癌的有效性及安全性[J].实用心脑肺血管病杂志,2017,25(7):106-108.
[10] HERTEL L,W,BODER G B,KROIN J S,et al. Evaluation of the antitumor activity of gemcitabine(2’,2’-difluoro-2’-deoxycytidine)[J]. J Cancer Res,1990,50(14):4417-44122.
[11]王倩,陈津红,韩琴,等. 441例抗结核药引起血液系统不良反应文献分析[J].中国药房,2008,19(5):376-377.
[12]王茹,郭代红,赵粟裕. 41 176例老年人药品不良反应报告分析[J].解放军医学院学报,2018,39(1):69-74.
[2]许家琏.肺结核与肺癌的关系[J].中国临床医生,2004,32(7):8-10.
[3]王倩,陈津红,韩琴,等. 441例抗结核药引起血液系统不良反应文献分析[J].中国药房,2008,19(5):376-377.
[4]宋越.抗结核药物致白细胞减少23例的临床分析及治疗[J].吉林医学,2012,33(34):7514.
[5]刘联,王秀问,黎莉,等.含顺铂的三组联合化疗方案治疗晚期非小细胞肺癌的随机对照临床研究[J].癌症,2006,25(8):990-994.
[6] OWONIKOKO T K,RAGIN C C,BELANI C P,et al. Lung cancer in elderly patients:an analysis of the surveillance,epidemiology,and end results database[J]. J Clin Oncol,2007,25(35):5570-5577
[7]高然,梁锦峰,陆泉,等. 2004-2015年中国大陆地区肺结核流行特征分析[J].现代预防医学,2018,45(14):2501-2504,2509.
[8]黄岩,刘云鹏,周建英,等.培美曲塞联合顺铂对比吉西他滨联合顺铂一线治疗晚期非鳞非小细胞肺癌的随机、对照、多中心临床研究[J].中国肺癌杂志,2012,10:576-582.
[9]王月,金建华,陆文斌,等.培美曲塞联合顺铂治疗中晚期非小细胞肺癌的有效性及安全性[J].实用心脑肺血管病杂志,2017,25(7):106-108.
[10] HERTEL L,W,BODER G B,KROIN J S,et al. Evaluation of the antitumor activity of gemcitabine(2’,2’-difluoro-2’-deoxycytidine)[J]. J Cancer Res,1990,50(14):4417-44122.
[11]王倩,陈津红,韩琴,等. 441例抗结核药引起血液系统不良反应文献分析[J].中国药房,2008,19(5):376-377.
[12]王茹,郭代红,赵粟裕. 41 176例老年人药品不良反应报告分析[J].解放军医学院学报,2018,39(1):69-74.