吉非替尼与重组人血管内皮抑制素注射液联合治疗非小细胞肺癌的临床疗效及安全性观察
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摘要
目的探讨吉非替尼与重组人血管内皮抑制素注射液联合治疗非小细胞肺癌的临床疗效及安全性。方法以河南省直第三人民医院2012年1月—2014年1月58例非小细胞肺癌化疗患者为研究对象,根据入院单双号将入选者随机分为对照组和研究组,每组29例,对照组患者单用吉非替尼治疗,研究组患者在此基础上联合重组人血管内皮抑制素注射液治疗,21 d为1个疗程,共进行4个疗程。比较两组患者的临床疗效、各肿瘤标志物水平变化、不良反应发生率及预后情况。结果研究组及对照组患者客观缓解率(ORR)分别为86.21%、55.17%,两组比较存在显著性差异(P<0.05)。治疗前两组患者各肿瘤标志物水平比较无显著性差异,治疗后两组患者各肿瘤标志物水平均显著降低,前后比较存在显著性差异(P<0.05);治疗后研究组患者各肿瘤标志物水平降低程度显著优于对照组,两组比较存在显著性差异(P<0.05)。随访3年后,研究组患者的生存率、中位生存期及中位无进展生存期均显著高于对照组,两组比较存在显著差异性(P<0.05),两组不良反应的发生率比较无显著性差异。结论吉非替尼与重组人血管内皮抑制素注射液联合应用可有效提高临床疗效,延长生存期,降低各肿瘤标志物水平,且不增加不良反应,安全性较高,值得在非小细胞肺癌的治疗中进行推广。
Objective To explore clinical efficacy and safety of Gefitinib combined with Endostar in treating non-small cell lung cancer(NSCLC). Methods 58 Patients with NSCLC were selected as the subjects from January 2013 to January 2015. According to the admission of single and double numbers were randomly divided into the control group and study group with 29 cases in each. The control group patients were treated with Gefitinib, the experimental group on the basis of this combination of Endostar. Compared the two groups of patients with clinical effect, tumor marker levels changes, incidence of adverse reactions and prognosis. Results The patients' ORR in the study group were 86.21%, which was significantly higher than in the control group(P < 0.05). Before treatment, there was no significant difference in the level of tumor markers between the two groups, after treatment, the level of tumor markers was significantly decreased in both groups and there were significant differences between before and after(P < 0.05). The level of tumor markers in the study group was significantly better than that in the control group(P < 0.05). After 3 years of follow-up, the survival rate, median survival and median progression-free survival of the study group were significantly higher than those of the control group and there was significant difference(P < 0.05), The incidence of adverse reactions had no statistically significant differences between the two groups. Conclusions Gefitinib combined with Endostar in treating NSCLC can effectively improve clinical effect, extend the survival period, reduce the level of tumor markers, don't increase the adverse reactions and higher safety, which has worthy of promotion.
Objective To explore clinical efficacy and safety of Gefitinib combined with Endostar in treating non-small cell lung cancer(NSCLC). Methods 58 Patients with NSCLC were selected as the subjects from January 2013 to January 2015. According to the admission of single and double numbers were randomly divided into the control group and study group with 29 cases in each. The control group patients were treated with Gefitinib, the experimental group on the basis of this combination of Endostar. Compared the two groups of patients with clinical effect, tumor marker levels changes, incidence of adverse reactions and prognosis. Results The patients' ORR in the study group were 86.21%, which was significantly higher than in the control group(P < 0.05). Before treatment, there was no significant difference in the level of tumor markers between the two groups, after treatment, the level of tumor markers was significantly decreased in both groups and there were significant differences between before and after(P < 0.05). The level of tumor markers in the study group was significantly better than that in the control group(P < 0.05). After 3 years of follow-up, the survival rate, median survival and median progression-free survival of the study group were significantly higher than those of the control group and there was significant difference(P < 0.05), The incidence of adverse reactions had no statistically significant differences between the two groups. Conclusions Gefitinib combined with Endostar in treating NSCLC can effectively improve clinical effect, extend the survival period, reduce the level of tumor markers, don't increase the adverse reactions and higher safety, which has worthy of promotion.
引文
[1]敖翔,周天骏,姜明,等.DP、吉非替尼联合恩度治疗非小细胞肺癌的疗效分析[J].肿瘤药学,2017,7(03):350-354.
[2]高春蕾.吉非替尼单用及与恩度联用治疗晚期非小细胞肺癌的临床疗效分析[D].大连:大连医科大学,2010.
[3]赵培革.恩度联合顺铂治疗晚期非小细胞肺癌临床分析[J].中国医药科学,2013,3(20):47-48.
[4]邹慧兰,杨涛,陈仁贵,等.恩度联合含铂类化疗药物用于治疗非小细胞肺癌合并心律不齐患者的疗效分析[J].肿瘤药学,2017,7(01):50-54.
[5]徐彩虹,陈俊.贝伐单抗联合吉非替尼片治疗非小细胞肺癌的临床研究[J].中国临床药理学杂志,2017,33(08):684-686.
[6]万莉娟,肖丹,邹俊韬,等.含铂类化疗药物联合恩度治疗晚期非小细胞肺癌的临床疗效及安全性[J].长江大学学报:自然科学版,2015,12(36):41-42.
[7]汪露,江涛.重组人血管内皮抑制素联合化疗治疗晚期非小细胞肺癌的临床观察[J].中国药房,2014,25(46):4361-4364.
[8]张建波,王祥麒,于庆凯,等.吉非替尼对非小细胞肺癌的疗效与T细胞亚群变化分析[J].现代药物与临床,2009,24(5):298-300.
[9]李海燕.恩度联合化疗治疗中晚期非小细胞肺癌的疗效观察及评价[J].临床医学研究与实践,2016,1(10):59.
[10]Qian X,Yan B,Zhou X,et al.Synergistic antiangiogenic activity of tetrandrine combined with endostar on the human umbilical vein endothelial cell model[J].Cancer Biother Radiopharmac,2013,28(5):385-390.
[11]刘文静,曾宪涛,刘晓晴,等.恩度联合化疗治疗晚期非小细胞肺癌疗效和安全性的系统评价[J].中国循证医学杂志,2011,11(11):1268-1279.
[12]凌华晃,黄锡梅,李涛,等.恩度联合化疗治疗中晚期非小细胞肺癌的疗效及相关因素分析[J].中国肿瘤临床与康复,2015,22(3):295-297.
[13]蔡萍,姜亚莉,顾平荣,等.恩度治疗非小细胞肺癌30例临床疗效及安全性观察[J].中国药业,2015,24(8):58-60.
[14]Young H S,Yong J O.Synthesis of flavokawain B and its anti-proliferative activity against gefitinib-resistant non-small cell lung cancer(NSCLC)[J].Bull Kor Chem Soc,2013,34(12):3782-3786.
[15]朱志真,石建华,侯森.恩度联合顺铂局部治疗非小细胞肺癌合并恶性胸腔积液的疗效及对VEGF、HIF-1α的影响[J].实用癌症杂志,2014,29(7):855-857.
[16]汪力慧.恩度联合化疗与单纯应用化疗治疗晚期非小细胞肺癌的疗效比较[J].中国老年学杂志,2013,33(06):1384-1385.
[2]高春蕾.吉非替尼单用及与恩度联用治疗晚期非小细胞肺癌的临床疗效分析[D].大连:大连医科大学,2010.
[3]赵培革.恩度联合顺铂治疗晚期非小细胞肺癌临床分析[J].中国医药科学,2013,3(20):47-48.
[4]邹慧兰,杨涛,陈仁贵,等.恩度联合含铂类化疗药物用于治疗非小细胞肺癌合并心律不齐患者的疗效分析[J].肿瘤药学,2017,7(01):50-54.
[5]徐彩虹,陈俊.贝伐单抗联合吉非替尼片治疗非小细胞肺癌的临床研究[J].中国临床药理学杂志,2017,33(08):684-686.
[6]万莉娟,肖丹,邹俊韬,等.含铂类化疗药物联合恩度治疗晚期非小细胞肺癌的临床疗效及安全性[J].长江大学学报:自然科学版,2015,12(36):41-42.
[7]汪露,江涛.重组人血管内皮抑制素联合化疗治疗晚期非小细胞肺癌的临床观察[J].中国药房,2014,25(46):4361-4364.
[8]张建波,王祥麒,于庆凯,等.吉非替尼对非小细胞肺癌的疗效与T细胞亚群变化分析[J].现代药物与临床,2009,24(5):298-300.
[9]李海燕.恩度联合化疗治疗中晚期非小细胞肺癌的疗效观察及评价[J].临床医学研究与实践,2016,1(10):59.
[10]Qian X,Yan B,Zhou X,et al.Synergistic antiangiogenic activity of tetrandrine combined with endostar on the human umbilical vein endothelial cell model[J].Cancer Biother Radiopharmac,2013,28(5):385-390.
[11]刘文静,曾宪涛,刘晓晴,等.恩度联合化疗治疗晚期非小细胞肺癌疗效和安全性的系统评价[J].中国循证医学杂志,2011,11(11):1268-1279.
[12]凌华晃,黄锡梅,李涛,等.恩度联合化疗治疗中晚期非小细胞肺癌的疗效及相关因素分析[J].中国肿瘤临床与康复,2015,22(3):295-297.
[13]蔡萍,姜亚莉,顾平荣,等.恩度治疗非小细胞肺癌30例临床疗效及安全性观察[J].中国药业,2015,24(8):58-60.
[14]Young H S,Yong J O.Synthesis of flavokawain B and its anti-proliferative activity against gefitinib-resistant non-small cell lung cancer(NSCLC)[J].Bull Kor Chem Soc,2013,34(12):3782-3786.
[15]朱志真,石建华,侯森.恩度联合顺铂局部治疗非小细胞肺癌合并恶性胸腔积液的疗效及对VEGF、HIF-1α的影响[J].实用癌症杂志,2014,29(7):855-857.
[16]汪力慧.恩度联合化疗与单纯应用化疗治疗晚期非小细胞肺癌的疗效比较[J].中国老年学杂志,2013,33(06):1384-1385.