沙利度胺联合化疗和单纯化疗在肺癌患者中的疗效对比观察及对死亡率的影响
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摘要
目的:探讨沙利度胺联合化疗和单纯化疗在肺癌患者中的疗效和对死亡率的影响。方法:回顾性分析2016年2月—2017年2月来我院就诊的82例肺癌患者,根据治疗方案的不同,分为观察组(n=42)和对照组(n=40)。其中观察组给予沙利度胺联合基础化疗方案进行治疗,对照组只给予单纯化疗,比较两组患者的近期疗效、血清VEGF水平、远期疗效、死亡率以及不良反应发生情况。结果:观察组的RR为47.6%,CBR为76.2%,对照组RR为37.5%,CBR为57.5%,差异无统计学意义,P>0.05;治疗前,两组患者血清VEGF水平无显著差异,治疗两周后,观察组和对照组的血清VEGF水平均下降,且观察组的下降程度更显著,差异有统计学意义,P<0.05;观察组的OS为(12.7±1.8)月,PFS为(7.9±0.8),对照组的OS为(11.3±1.6)月,PFS为(5.6±0.7),观察组的OS和PFS均比对照组长,差异有统计学意义,P<0.05;观察组患者死亡率显著低于对照组,差异有统计学意义,P<0.05;两组患者不良反应发生情况无显著差异,P>0.05。结论:沙利度胺联合化疗能显著延长患者的生存期,降低患者的死亡率,临床疗效显著,且安全性高。
Objective: To investigate the effect of thalidomide combined with chemotherapy and chemotherapy alone in patients with lung cancer and its effect on mortality. Methods: 82 patients with lung cancer who visited our hospital from 2016.02 to 2017.02 were divided into observation group(n=42) and control group(n=40) according to different treatment plans. The observation group was treated with thalidomide and basic chemotherapy. The control group was given chemotherapy alone. The short-term efficacy, serum VEGF level, long-term efficacy, mortality, and adverse reactions were compared between the two groups. Results: The RR of the observation group was 47.6%, the CBR was 76.2%, the RR of the control group was 37.5%, and the CBR was 57.5%. The difference was not statistically significant(P>0.05). Before treatment, there was no significant difference in serum VEGF levels between the two groups. After two weeks of treatment, serum VEGF levels in both the observation group and the control group decreased, and the degree of decline in the observation group was more significant, the difference was statistically significant(P<0.05); the OS of the observation group was(12.7±1.8) months, PFS For(7.9±0.8), the OS in the control group was(11.3±1.6) months, and the PFS was(5.6±0.7). OS and PFS in the observation group were longer than those in the control group, and the difference was statistically significant(P<0.05); The mortality rate of patients in the group was significantly lower than that of the control group, with a significant difference(P<0.05); there was no significant difference in the incidence of adverse reactions between the two groups, P>0.05. Conclusion: Thalidomide combined with chemotherapy can significantly prolong the survival of patients, reduce the patient's mortality, with high clinical efficacy and high safety, therefore, it is worthy of clinical application.
Objective: To investigate the effect of thalidomide combined with chemotherapy and chemotherapy alone in patients with lung cancer and its effect on mortality. Methods: 82 patients with lung cancer who visited our hospital from 2016.02 to 2017.02 were divided into observation group(n=42) and control group(n=40) according to different treatment plans. The observation group was treated with thalidomide and basic chemotherapy. The control group was given chemotherapy alone. The short-term efficacy, serum VEGF level, long-term efficacy, mortality, and adverse reactions were compared between the two groups. Results: The RR of the observation group was 47.6%, the CBR was 76.2%, the RR of the control group was 37.5%, and the CBR was 57.5%. The difference was not statistically significant(P>0.05). Before treatment, there was no significant difference in serum VEGF levels between the two groups. After two weeks of treatment, serum VEGF levels in both the observation group and the control group decreased, and the degree of decline in the observation group was more significant, the difference was statistically significant(P<0.05); the OS of the observation group was(12.7±1.8) months, PFS For(7.9±0.8), the OS in the control group was(11.3±1.6) months, and the PFS was(5.6±0.7). OS and PFS in the observation group were longer than those in the control group, and the difference was statistically significant(P<0.05); The mortality rate of patients in the group was significantly lower than that of the control group, with a significant difference(P<0.05); there was no significant difference in the incidence of adverse reactions between the two groups, P>0.05. Conclusion: Thalidomide combined with chemotherapy can significantly prolong the survival of patients, reduce the patient's mortality, with high clinical efficacy and high safety, therefore, it is worthy of clinical application.
引文
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[18]Liang J,Bi N,Wu S,et al.Etoposide and cisplatin versus paclitaxel and carboplatin with concurrent thoracic radiotherapy in unresectable stage IIInon-small cell lung cancer:a multicenter randomized phase III trial[J].Ann Oncol,2017,28(4):777-783.
[19]Xie M,Chen X,Qin S,et al.Clinical study on thalidomide combined with cinobufagin to treat lung cancer cachexia[J].J Cancer Res Ther,2018,14(1):226-232.
[20]Li L,Huang XE.Thalidomide Combined with Chemotherapy in Treating Patients with Advanced lung Cancer[J].Asian Pac J Cancer Prev,2016,17(5):2583-2585.
[21]Liu Y,He S,Ding Y,et al.The efficacy and safety of thalidomide-based therapy in patients with advanced non-small cell lung cancer:a metaanalysis[J].Contemp Oncol(Pozn),2014,18(1):39-47.
[2]Lin CC,Shih JY,Yu CJ,et al.Outcomes in patients with non-small-cell lung cancer and acquired Thr790Met mutation treated with osimertinib:a genomic study[J].Lancet Respir Med,2018,6(2):107-116.
[3]Anker MS,Ebner N,Hildebrandt B,et al.Resting heart rate is an independent predictor of death in patients with colorectal,pancreatic,and non-small cell lung cancer:results of a prospective cardiovascular longterm study[J].Eur J Heart Fail,2016,18(12):1524-1534.
[4]Takemura Y,Chihara Y,Morimoto Y,et al.Feasibility Study of Sequentially Alternating EGFR-TKIs and Chemotherapy for Patients with Non-small Cell Lung Cancer[J].Anticancer Res,2018,38(4):2385-2390.
[5]Tsuboi M,Kondo K,Takizawa H,et al.A feasibility study of postoperative adjuvant chemotherapy with fluoropyrimidine S-1 in patients with stage II-IIIA non-small cell lung cancer[J].J Med Invest,2018,65(1.2):90-95.
[6]Zhu YM,Gan YL,Xu HY,et al.Clinical effectiveness of pemetrexed combined with cisplatin chemotherapy for advanced and maintenance treatment for patients with non-small-cell lung cancer[J].Eur Rev Med Pharmacol Sci,2018,22(7):1943-1947.
[7]Yang Y,Zhou W,Wu J,et al.Antitumor activity of nimotuzumab in combination with cisplatin in lung cancer cell line A549 in vitro[J].Oncol Lett,2018,15(4):5280-5284.
[8]Chen J,Zhang L,Zhou H,et al.Inhibition of autophagy promotes cisplatininduced apoptotic cell death through Atg5 and Beclin 1 in A549 human lung cancer cells[J].Mol Med Rep,2018,17(5):6859-6865.
[9]Kang HJ,Park JH,Yoo HS,et al.Effects of HAD-B1 on the proliferation of A549 cisplatin-resistant lung cancer cells[J].Mol Med Rep,2018,17(5):6745-6751.
[10]彭晔,张旭刚,谢娜,等.沙利度胺联合紫杉醇+顺铂方案治疗老年晚期非小细胞肺癌的疗效观察[J].疑难病杂志,2014,13(01):49-52.
[11]Sakaizawa T,Matsumura T,Fujii C,et al.Potential Role of ASC,a Proapoptotic Protein,for Determining the Cisplatin Susceptibility of Lung Cancer Cells[J].Tohoku J Exp Med,2018,244(2):133-144.
[12]Wattanathamsan O,Treesuwan S,Sritularak B,et al.Cypripedin,a phenanthrenequinone from Dendrobium densiflorum,sensitizes non-small cell lung cancer H460 cells to cisplatin-mediated apoptosis[J].J Nat Med,2018,72(2):503-513.
[13]Middleton G,Gridelli C,De Marinis F,et al.Evaluation of changes in renal function in PARAMOUNT:a phase III study of maintenance pemetrexed plus best supportive care versus placebo plus best supportive care after induction treatment with pemetrexed plus cisplatin for advanced nonsquamous non-small-cell lung cancer[J].Curr Med Res Opin,2018,34(5):865-871.
[14]Taira T,Yoh K,Nagase S,et al.Long-term results of S-1 plus cisplatin with concurrent thoracic radiotherapy for locally advanced non-small-cell lung cancer[J].Cancer Chemother Pharmacol,2018,81(3):565-572.
[15]Han S,Hong Y,Liu T,et al.The efficacy and safety of paclitaxel and carboplatin with versus without bevacizumab in patients with non-smallcell lung cancer:a systematic review and meta-analysis[J].Oncotarget,2018,9(18):14619-14629.
[16]Gupta B,Poudel BK,Regmi S,et al.Paclitaxel and Erlotinib-coloaded Solid Lipid Core Nanocapsules:Assessment of Physicochemical Characteristics and Cytotoxicity in Non-small Cell Lung Cancer[J].Pharm Res,2018,35(5):96.
[17]Tian J,Min Y,Rodgers Z,et al.Co-delivery of paclitaxel and cisplatin with biocompatible PLGA-PEG nanoparticles enhances chemoradiotherapy in non-small cell lung cancer models[J].J Mater Chem B,2017,5(30):6049-6057.
[18]Liang J,Bi N,Wu S,et al.Etoposide and cisplatin versus paclitaxel and carboplatin with concurrent thoracic radiotherapy in unresectable stage IIInon-small cell lung cancer:a multicenter randomized phase III trial[J].Ann Oncol,2017,28(4):777-783.
[19]Xie M,Chen X,Qin S,et al.Clinical study on thalidomide combined with cinobufagin to treat lung cancer cachexia[J].J Cancer Res Ther,2018,14(1):226-232.
[20]Li L,Huang XE.Thalidomide Combined with Chemotherapy in Treating Patients with Advanced lung Cancer[J].Asian Pac J Cancer Prev,2016,17(5):2583-2585.
[21]Liu Y,He S,Ding Y,et al.The efficacy and safety of thalidomide-based therapy in patients with advanced non-small cell lung cancer:a metaanalysis[J].Contemp Oncol(Pozn),2014,18(1):39-47.