贝伐珠单抗联合阿法替尼治疗非小细胞肺癌临床疗效观察
|
摘要
目的:探究贝伐珠单抗联合阿法替尼治疗非小细胞肺癌临床疗效。方法:研究对象选取我院收治的非小细胞肺癌患者98例,随机分为对照组(49例)及实验组(49例),对照组给予常规一线化疗(培美曲塞~+卡铂)治疗,实验组在其基础上加用贝伐珠单抗联合阿法替尼进行治疗,观察两组治疗疗效,记录并比较两组治疗前后免疫功能、血管新生相关指标及不良反应发生率。结果:两组治疗前CD3~+、CD4~+、CD4~+/CD8~+、IgG、IgM、IgA及VEGF、BFGF、HDGF水平比较,差异无统计学意义(P>0.05);治疗后,两组均降低,且实验组CD3~+、CD4~+、CD4~+/CD8~+、IgG、IgM、IgA水平高于对照组,VEGF、BFGF、HDGF水平低于对照组,实验组治疗有效率高于对照组,差异均具有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:贝伐珠单抗联合阿法替尼能有效提高非小细胞肺癌患者治疗疗效,抑制其血管新生因子的表达,提高患者免疫功能且不增加患者不良反应,值得临床推广。
Objective:To investigate the clinical efficacy of bevacizumab combined with afatinib in the treatment of nonsmall cell lung cancer.Methods:Ninety-eight patients with non-small cell lung cancer admitted to our hospital from December2014 to December 2017 were randomly divided into the control group(49 cases)and the experimental group(49 cases).The group was treated with conventional first-line chemotherapy(pemetrexed plus carboplatin).The experimental group was treated with bevacizumab plus afatinib.The therapeutic effects of the two groups were observed.Immune function,angiogenesis related indicators and incidence of adverse reactions.Results:The levels of CD3~+,CD4~+,CD4~+/CD8~+,IgG,IgM,IgA,VEGF,BFGF and HDGF were not significantly different between the two groups(P>0.05).After treatment,both groups were reduced,and the experimental group the levels of CD3~+,CD4~+,CD4~+/CD8~+,IgG,IgM and IgA were significantly higher than those of the control group.The levels of VEGF,BFGF and HDGF were significantly lower than those of the con-trol group.The effective rate of the experimental group was significantly higher than that of the control group(P<0.05).There was no significant difference in the rate(P>0.05). Conclusion:Bevacizumab combined with afatinib can effectively improve the therapeutic effect of patients with non-small cell lung cancer.It has been the expression of angiogenic factors,improve the immune function of patients and increase the adverse reactions of patients,which is worthy of clinical promotion.
Objective:To investigate the clinical efficacy of bevacizumab combined with afatinib in the treatment of nonsmall cell lung cancer.Methods:Ninety-eight patients with non-small cell lung cancer admitted to our hospital from December2014 to December 2017 were randomly divided into the control group(49 cases)and the experimental group(49 cases).The group was treated with conventional first-line chemotherapy(pemetrexed plus carboplatin).The experimental group was treated with bevacizumab plus afatinib.The therapeutic effects of the two groups were observed.Immune function,angiogenesis related indicators and incidence of adverse reactions.Results:The levels of CD3~+,CD4~+,CD4~+/CD8~+,IgG,IgM,IgA,VEGF,BFGF and HDGF were not significantly different between the two groups(P>0.05).After treatment,both groups were reduced,and the experimental group the levels of CD3~+,CD4~+,CD4~+/CD8~+,IgG,IgM and IgA were significantly higher than those of the control group.The levels of VEGF,BFGF and HDGF were significantly lower than those of the con-trol group.The effective rate of the experimental group was significantly higher than that of the control group(P<0.05).There was no significant difference in the rate(P>0.05). Conclusion:Bevacizumab combined with afatinib can effectively improve the therapeutic effect of patients with non-small cell lung cancer.It has been the expression of angiogenic factors,improve the immune function of patients and increase the adverse reactions of patients,which is worthy of clinical promotion.
引文
1 Chen W,Zheng R,Baade PD,et al.Cancer statistics in China,2015[J].CA:A Cancer Journal for Clinicians,2016,66(2):7-30.
2 Siegel RL,Miller KD,Jemal Al.Cancer statistics in China,2016[J].CA:A Cancer Journal for Clinicians,2016,66(2):115-132.
3 Vijayvergia N,Mehra R.Clinical challenges in targeting anaplastic lymphoma kinase in advanced non-small cell lung cancer[J].Cancer Chemother Pharmacol,2014,74(3):437-446.
4陈刚,邬冬强.贝伐珠单抗注射液辅助治疗老年局部非小细胞肺癌的临床研究[J].中国临床药理学杂志,2016,32(21):1967-1970.
5张凯恋,褚倩,陈元.非小细胞肺癌抗血管生成药物治疗进展[J].医药导报,2018,5:546-550.
6 Mihajlovi'c J,Pechlivanoglou P,Miladinov-Mikov M,et al.Cancer incidence and mortality in Serbia 1999-2009[J].BMC Cancer,2013,13(1):18.
7薛渊博.阿法替尼在NSCLC中的应用与展望[J].实用肿瘤杂志,2016,31(2):104-107.
8石荟,白冲.晚期非小细胞肺癌抗血管生成药物治疗中国呼吸领域专家共识解读(2016年版)[J].中国实用内科杂志,2017,37(2):127-131.
9 D’Arcangelo M,Hirsch FR.Clinical and comparative utility of afatinib in non-small cell lung cancer[J].Biologics Targets&Therapy,2014,8(default):183-192.
10 Zhao M,Gao FH,Wang JY,et al.JAK2/STAT3signaling pathway activation mediates tumor angiogenesis by upregulation of VEGF and bFGF in non-small-cell lung cancer[J].Lung Cancer,2011,73(3):366-374.
11 Giri K,Pabelick C,Mukherjee P,et al.Hepatoma-derived growth factor(HDGF)acts in ovarian cancer via distinct intracellular and extracellular mechanisms[J].FASEB J,2015,29(1Suppl):726.
12汪正广,齐东江,李嘉嘉,等.中晚期胃癌患者术后化疗联合黄芪颗粒治疗对生活质量及免疫功能的影响[J].安徽医科大学学报,2014,49(12):1771-1774.
13刘华丽,许斌,韩光,等.EGFR-TKI在非小细胞肺癌中的研究进展[J].中国肿瘤,2018,27(4):285-293.
2 Siegel RL,Miller KD,Jemal Al.Cancer statistics in China,2016[J].CA:A Cancer Journal for Clinicians,2016,66(2):115-132.
3 Vijayvergia N,Mehra R.Clinical challenges in targeting anaplastic lymphoma kinase in advanced non-small cell lung cancer[J].Cancer Chemother Pharmacol,2014,74(3):437-446.
4陈刚,邬冬强.贝伐珠单抗注射液辅助治疗老年局部非小细胞肺癌的临床研究[J].中国临床药理学杂志,2016,32(21):1967-1970.
5张凯恋,褚倩,陈元.非小细胞肺癌抗血管生成药物治疗进展[J].医药导报,2018,5:546-550.
6 Mihajlovi'c J,Pechlivanoglou P,Miladinov-Mikov M,et al.Cancer incidence and mortality in Serbia 1999-2009[J].BMC Cancer,2013,13(1):18.
7薛渊博.阿法替尼在NSCLC中的应用与展望[J].实用肿瘤杂志,2016,31(2):104-107.
8石荟,白冲.晚期非小细胞肺癌抗血管生成药物治疗中国呼吸领域专家共识解读(2016年版)[J].中国实用内科杂志,2017,37(2):127-131.
9 D’Arcangelo M,Hirsch FR.Clinical and comparative utility of afatinib in non-small cell lung cancer[J].Biologics Targets&Therapy,2014,8(default):183-192.
10 Zhao M,Gao FH,Wang JY,et al.JAK2/STAT3signaling pathway activation mediates tumor angiogenesis by upregulation of VEGF and bFGF in non-small-cell lung cancer[J].Lung Cancer,2011,73(3):366-374.
11 Giri K,Pabelick C,Mukherjee P,et al.Hepatoma-derived growth factor(HDGF)acts in ovarian cancer via distinct intracellular and extracellular mechanisms[J].FASEB J,2015,29(1Suppl):726.
12汪正广,齐东江,李嘉嘉,等.中晚期胃癌患者术后化疗联合黄芪颗粒治疗对生活质量及免疫功能的影响[J].安徽医科大学学报,2014,49(12):1771-1774.
13刘华丽,许斌,韩光,等.EGFR-TKI在非小细胞肺癌中的研究进展[J].中国肿瘤,2018,27(4):285-293.