CT引导下射频消融联合EGFR-TKI靶向治疗中晚期非小细胞肺癌的效果及对免疫功能的影响
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摘要
目的探讨CT引导下射频消融联合EGFR-TKI靶向治疗中晚期非小细胞肺癌(NSCLC)的效果及对免疫功能的影响。方法选取108例中晚期NSCLC患者,将接受射频消融联合GP方案化疗的53例患者作为对照组,将接受射频消融联合EGFR-TKI靶向治疗的55例患者作为观察组。比较2组患者免疫功能指标、生命质量指标等。结果治疗后2组患者CD_3~+、CD_4~+和CD_4~+/CD_8~+ 水平显著升高,CD_8~+ 水平显著下降,且观察组CD_3~+、CD_4~+和CD_4~+/CD_8~+ 水平显著高于对照组,CD_8~+ 水平显著低于对照组(P<0.05)。治疗后观察组IgG、IgM、IgA指标上升,对照组IgG、IgM、IgA指标下降,差异有统计学意义(P<0.05)。治疗后2组患者角色、躯体、情绪、认知、社会功能等指标均显著升高,其中观察组显著高于对照组(P<0.05);2组患者恶心呕吐、疲劳、便秘、腹泻、睡眠障碍、疼痛等指标显著降低,观察组显著低于对照组(P<0.05)。观察组临床治疗总有效率为95.45%,显著高于对照组的45.28%(P<0.05)。观察组治疗后1年、2年生存率均高于对照组(P>0.05)。结论 CT引导下射频消融联合EGFR-TKI靶向治疗能够显著提高中晚期NSCLC患者临床治疗效果,改善免疫功能,提高生命质量。
Objective To investigate the effect of CT-guided radiofrequency ablation combined with EGFR-TKI targeted therapy on the treatment of advanced non-small cell lung cancer( NSCLC) and its influence on immune function. Methods A total of 108 middle and late NSCLC patients who were treated in our hospital were be chosen as study objects. A total of 53 patients undergoing radiofrequency ablation combined with GP therapy were selected as control group,while 55 patients undergoing radiofrequency ablation combined with EGFR-TKI targeted therapy were selected as observation group. The immune function index and life quality index of the two groups were compared. Results After treatment,the levels of CD_3~+,CD_4~+and CD_4~+/CD_8~+ were increased and CD_8~+ level was decreased in the two groups,and were significantly higher,and lower,respectively,in observation group than the control group( P < 0. 05). After treatment,the indicators of IgG,IgM and IgA in the observation group were increased,and the IgG,IgM and IgA in the control group were decreased( P < 0. 05). Physical,emotional,cognitive roles,social function and other indicators of two groups were significantly increased,and the observation group was significantly higher than the control group( P < 0. 05). Complications such as Nausea and vomiting,constipation,diarrhea,fatigue,sleep disorder,pain of two groups were decreased significantly,and the observation group was significantly lower than the control group( P < 0. 0 5). The total effective rate of clinical treatment in the observation group was 95. 45%,which was significantly higher than 45. 28% of the control group( P < 0. 05). The 1,2-year survival rates after treatment in the observation group were higher than that in the control group,but there was no statistical difference in two groups( P > 0. 05).Conclusion CT-guided radiofrequency ablation combined with EGFR-TKI targeted therapy can significantly improve clinical therapeutic effect,improve immune function and quality of life in patients with advanced NSCLC.
Objective To investigate the effect of CT-guided radiofrequency ablation combined with EGFR-TKI targeted therapy on the treatment of advanced non-small cell lung cancer( NSCLC) and its influence on immune function. Methods A total of 108 middle and late NSCLC patients who were treated in our hospital were be chosen as study objects. A total of 53 patients undergoing radiofrequency ablation combined with GP therapy were selected as control group,while 55 patients undergoing radiofrequency ablation combined with EGFR-TKI targeted therapy were selected as observation group. The immune function index and life quality index of the two groups were compared. Results After treatment,the levels of CD_3~+,CD_4~+and CD_4~+/CD_8~+ were increased and CD_8~+ level was decreased in the two groups,and were significantly higher,and lower,respectively,in observation group than the control group( P < 0. 05). After treatment,the indicators of IgG,IgM and IgA in the observation group were increased,and the IgG,IgM and IgA in the control group were decreased( P < 0. 05). Physical,emotional,cognitive roles,social function and other indicators of two groups were significantly increased,and the observation group was significantly higher than the control group( P < 0. 05). Complications such as Nausea and vomiting,constipation,diarrhea,fatigue,sleep disorder,pain of two groups were decreased significantly,and the observation group was significantly lower than the control group( P < 0. 0 5). The total effective rate of clinical treatment in the observation group was 95. 45%,which was significantly higher than 45. 28% of the control group( P < 0. 05). The 1,2-year survival rates after treatment in the observation group were higher than that in the control group,but there was no statistical difference in two groups( P > 0. 05).Conclusion CT-guided radiofrequency ablation combined with EGFR-TKI targeted therapy can significantly improve clinical therapeutic effect,improve immune function and quality of life in patients with advanced NSCLC.
引文
[1]赵雷磊,张媛,周金培,等.非小细胞肺癌靶向治疗药物的研究进展[J].中国药科大学学报,2014,45(02):136-144.
[2]支修益,吴一龙,马胜林,等.原发性肺癌诊疗规范(2011年版)[J].中国肺癌杂志,2012,15(12):677-688.
[3]朱星宇,王惠琴.应用EGFR-TK靶向治疗非小细胞肺癌的临床分析[J].临床医学研究与实践,2017,2(21):15-16.
[4]杜淑卉,秦达,庞睿奇,等.射频消融术联合化疗治疗进展期非小细胞肺癌远期疗效的回顾性研究[J].中国肺癌杂志,2017,20(10):675-682.
[5]林称意.埃罗替尼靶向治疗对非小细胞肺癌患者免疫功能及临床疗效的影响[J].海南医学院学报,2015,21(04):547-549.
[6]蔡秋玲.微波消融、唯美生序贯多西他赛方案化疗治疗老年晚期非小细胞肺癌临床观察[J].肿瘤基础与临床,2017,30(04):328-331.
[7]蒋娟,胡成平.非小细胞肺癌EGFR-TKI治疗临床获益后颅内转移机制研究进展[J].中国肺癌杂志,2015,18(08):518-522.
[8]张宗城,叶桦,岑建宁,等.消融联合化疗和(或)靶向药物治疗老年非小细胞肺癌的临床疗效[J].中国老年学杂志,2015,35(03):651-652.
[9]邢世贵,许永.CT引导下射频消融治疗中晚期非小细胞肺癌的近期疗效分析[J].中外医学研究,2016,14(15):139-140.
[10]邱菊香,严海莹,刘照平,等.冷冻消融对非小细胞肺癌免疫功能的影响[J].解放军医药杂志,2016,28(S1):48-50.
[11]刘宝东,李元博,胡牧,等.对高度可疑肺癌同时进行CT引导下肺穿刺活检和射频消融的临床研究[J].中国微创外科杂志,2017,17(01):7-10,14.
[12]秦虹,张科乾,李文花,等.非小细胞肺癌脑转移全脑放疗联合靶向药物治疗系统评价[J].中华肿瘤防治杂志,2015,22(04):300-304.
[13]张艳,刘晶,杨梦迪.非小细胞肺癌晚期靶向药物治疗中血清肿瘤标志物预测疗效的临床意义[J].临床药物治疗杂志,2014,12(05):35-39.
[14]于淼,李茵茵,刘强.射频消融联合分子靶向药物(EGFR-TKI)治疗老年非小细胞肺癌的临床疗效[J].实用癌症杂志,2017,32(02):292-294.
[15]郭世钊,余敏,林玉蓉,等.CT引导下射频消融联合靶向治疗对中晚期非小细胞肺癌患者免疫功能的影响[J].中国医药导报,2016,13(29):79-82,90.
[2]支修益,吴一龙,马胜林,等.原发性肺癌诊疗规范(2011年版)[J].中国肺癌杂志,2012,15(12):677-688.
[3]朱星宇,王惠琴.应用EGFR-TK靶向治疗非小细胞肺癌的临床分析[J].临床医学研究与实践,2017,2(21):15-16.
[4]杜淑卉,秦达,庞睿奇,等.射频消融术联合化疗治疗进展期非小细胞肺癌远期疗效的回顾性研究[J].中国肺癌杂志,2017,20(10):675-682.
[5]林称意.埃罗替尼靶向治疗对非小细胞肺癌患者免疫功能及临床疗效的影响[J].海南医学院学报,2015,21(04):547-549.
[6]蔡秋玲.微波消融、唯美生序贯多西他赛方案化疗治疗老年晚期非小细胞肺癌临床观察[J].肿瘤基础与临床,2017,30(04):328-331.
[7]蒋娟,胡成平.非小细胞肺癌EGFR-TKI治疗临床获益后颅内转移机制研究进展[J].中国肺癌杂志,2015,18(08):518-522.
[8]张宗城,叶桦,岑建宁,等.消融联合化疗和(或)靶向药物治疗老年非小细胞肺癌的临床疗效[J].中国老年学杂志,2015,35(03):651-652.
[9]邢世贵,许永.CT引导下射频消融治疗中晚期非小细胞肺癌的近期疗效分析[J].中外医学研究,2016,14(15):139-140.
[10]邱菊香,严海莹,刘照平,等.冷冻消融对非小细胞肺癌免疫功能的影响[J].解放军医药杂志,2016,28(S1):48-50.
[11]刘宝东,李元博,胡牧,等.对高度可疑肺癌同时进行CT引导下肺穿刺活检和射频消融的临床研究[J].中国微创外科杂志,2017,17(01):7-10,14.
[12]秦虹,张科乾,李文花,等.非小细胞肺癌脑转移全脑放疗联合靶向药物治疗系统评价[J].中华肿瘤防治杂志,2015,22(04):300-304.
[13]张艳,刘晶,杨梦迪.非小细胞肺癌晚期靶向药物治疗中血清肿瘤标志物预测疗效的临床意义[J].临床药物治疗杂志,2014,12(05):35-39.
[14]于淼,李茵茵,刘强.射频消融联合分子靶向药物(EGFR-TKI)治疗老年非小细胞肺癌的临床疗效[J].实用癌症杂志,2017,32(02):292-294.
[15]郭世钊,余敏,林玉蓉,等.CT引导下射频消融联合靶向治疗对中晚期非小细胞肺癌患者免疫功能的影响[J].中国医药导报,2016,13(29):79-82,90.