重组人血管内皮抑制素注射液联合吉非替尼治疗晚期非小细胞肺癌的临床观察
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摘要
目的观察重组人血管内皮抑制素联合吉非替尼治疗晚期非小细胞肺癌的临床疗效及不良反应。方法将晚期非小细胞肺癌患者50例随机分为试验组和对照组各25例。对照组给予吉非替尼治疗,试验组在对照组治疗的基础上给予重组人血管内皮抑制素治疗。比较2组临床疗效、治疗前后肿瘤标志物变化及药物不良反应。结果试验组总缓解率为76. 0%高于对照组的56. 0%,差异有统计学意义(P <0. 05)。治疗前2组血清中CEA、CYFRA21-1及VEGF水平比较差异均无统计学意义(P> 0. 05),治疗后2组血清CEA、CYFRA21-1及VEGF水平均降低,且试验组低于对照组,差异均有统计学意义(P <0. 05)。2组药物不良反应发生率比较差异无统计学意义(P>0. 05)。结论重组人血管内皮抑制素联合吉非替尼片治疗非小细胞肺癌具有较好的临床疗效,血清肿瘤标志物(CEA、CYFRA21-1)及VEGF降低,且未增加药物不良反应的发生率,有临床推广意义。
Objective To observe the clinical efficacy and adverse reactions of recombinant human endostatin combined with gefitinib in the treatment of advanced non-small cell lung cancer. Methods 50 patients with advanced non-small cell lung cancer were randomly divided into the experimental group( 25 cases) and the control group( 25 cases). The control group was given gefitinib treatment,the experimental group was given recombinant human endostatin treatment on the basis of the control group. The clinical efficacy of the two groups,the changes of tumor markers before and after treatment and the adverse drug reactions of the two groups were compared. Results The total response rate of the experimental group( 76. 0%) was higher than that of the control group( 56. 0%),and the difference was statistically significant( P < 0. 05). There were no significant differences in the levels of serum CEA,CYFRA21-1 and VEGF between the two groups before treatment( P > 0. 05). After treatment,the levels of serum CEA,CYFRA21-1 and VEGF decreased in the two groups,and the levels of serum CEA,CYFRA21-1 and VEGF of the experimental group were lower than those of the control group,and the difference was statistically significant( P < 0. 05). There was no significant difference in the incidence of adverse drug reactions between the two groups( P > 0. 05). Conclusion Recombinant human endostatin combined with gefitinib tablets have a good clinical effect in the treatment of non-small cell lung cancer,serum tumor markers( CEA,CYFRA21-1) and VEGF are reduced,and the incidence of adverse drug reactions is not increased,which has clinical significance.
Objective To observe the clinical efficacy and adverse reactions of recombinant human endostatin combined with gefitinib in the treatment of advanced non-small cell lung cancer. Methods 50 patients with advanced non-small cell lung cancer were randomly divided into the experimental group( 25 cases) and the control group( 25 cases). The control group was given gefitinib treatment,the experimental group was given recombinant human endostatin treatment on the basis of the control group. The clinical efficacy of the two groups,the changes of tumor markers before and after treatment and the adverse drug reactions of the two groups were compared. Results The total response rate of the experimental group( 76. 0%) was higher than that of the control group( 56. 0%),and the difference was statistically significant( P < 0. 05). There were no significant differences in the levels of serum CEA,CYFRA21-1 and VEGF between the two groups before treatment( P > 0. 05). After treatment,the levels of serum CEA,CYFRA21-1 and VEGF decreased in the two groups,and the levels of serum CEA,CYFRA21-1 and VEGF of the experimental group were lower than those of the control group,and the difference was statistically significant( P < 0. 05). There was no significant difference in the incidence of adverse drug reactions between the two groups( P > 0. 05). Conclusion Recombinant human endostatin combined with gefitinib tablets have a good clinical effect in the treatment of non-small cell lung cancer,serum tumor markers( CEA,CYFRA21-1) and VEGF are reduced,and the incidence of adverse drug reactions is not increased,which has clinical significance.
引文
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[2]Lee SM,Khan I,Upadhyay S,et al.First-line erlotinib in patients with advanced non-small-cell lung cancer unsuitable for chemotherapy(TOPICAL):a double-blind,placebo-controlled,phase 3 trial[J].Lancet Oncol,2012,13(11):1161-1170.DOI:10.1016/S1470-2045(12)70412-6.
[3]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(8):684-686.DOI:10.13699/j.cnki.1001-6821.2017.08.004.
[4]刘孝民.吉非替尼对比培美曲塞治疗晚期非鳞非小细胞肺癌的临床疗效及安全性评价[J].中国临床药理学杂志,2015,31(24):2393-2395.DOI:10.13699/j.cnki.1001-6821.2015.24.007.
[5]王长林,任明华.内皮抑素及其在肿瘤治疗中的应用研究进展[J].国际遗传学杂志,2010,33(5):298-302.DOI:10.3760/cma.j.issn.1673-4386.2010.05.010.
[6]Ji Z,Bi N,Wang J,et al.Risk factors for brain metastases in locally advanced non-small cell lung cancer with definitive chest radiation[J].Int J Radiat Oncol Biol Phys,2014,89(2):330-337.DOI:10.1016/j.ijrobp.2014.02.025.
[7]吴文娟,顾亮.k-RAS基因突变与吉非替尼治疗非小细胞肺癌疗效的相关性研究[J].中国临床药理学杂志,2014,30(10):898-900.DOI:10.13699/j.cnki.1001-6821.2014.10.008.
[8]宋霆婷,盖慧荣,李伟,胡芳娟.吉非替尼治疗晚期非小细胞肺癌的疗效观察[J].疑难病杂志,2015,14(8):778-781.DOI:10.3969/j.issn.1671-6450.2015.08.003.
[9]Chaudhary S,Kanwar RK,Kanwar JR.Targeted Theranostics Against Solid Cancer Using Metal Bond Milk Protein and Aptamers[J].Curr Top Med Chem,2017,17(18):2100-2111.DOI:10.2174/1568026617666170130110021.
[10]Walker MJ,Zhou C,Backen A,et al.Discovery and Validation of Predictive Biomarkers of Survival for Non-small Cell Lung Cancer Patients Undergoing Radical Radiotherapy:Two Proteins With Predictive Value[J].EBioMedicine,2015,2(8):841-850.DOI:10.1016/j.ebiom.2015.06.013.