贝伐珠单抗联合化疗对肺腺癌患者恶性胸腔积液的疗效及安全性研究
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摘要
目的探讨贝伐珠单抗联合化疗对肺腺癌患者恶性胸腔积液的疗效及安全性研究。方法选取住院治疗的92例肺腺癌患者为研究对象,并依据随机数字表法分为治疗组(n=46)和对照组(n=46)。对照组患者仅给予常规化疗,治疗组患者在对照组患者治疗的基础上加用贝伐珠单抗。比较两组患者恶性胸腔积液治疗效果;检测并比较两组患者血清肿瘤标志物水平变化;比较两组患者胸腔积液中血管内皮生长因子(VEGF)水平和卡氏功能评分(KPS)变化;统计两组患者不良反应发生情况。结果治疗组的恶性胸腔积液治疗效果较对照组显著升高,且两组间差异有统计学意义(P <0.05)。与治疗前相比,治疗后两组患者细胞角蛋白19片段(CK-19)、肿瘤特异性生长因子(TSGF)以及癌胚抗原(CEA)均明显降低,且治疗组显著低于对照组(P <0.05)。与治疗前相比,治疗后两组患者KPS评分明显升高,且治疗组显著高于对照组(P <0.05),胸水VEGF水平明显降低,且治疗组显著低于对照组(P <0.05)。治疗期间两组不良反应发生率经统计学比较,差异均无统计学意义(P均> 0.05)。结论贝伐珠单抗联合化疗治疗肺腺癌患者可明显改善其临床症状,疗效佳,且安全可靠。
Objective To investigate the efficacy and safety of bevacizumab combined with chemotherapy for malignant pleural effusion in patients with lung adenocarcinoma.Methods 92 cases of lung adenocarcinoma patients hospitalized were selected as the study subjects,and were divided into treatment group(n = 46) and control group(n =46) according to the random number table method.Patients in the control group were only given chemotherapy,and patients in the treatment group were treated with bevacizumab based on the treatment of patients in the control group.Between two groups,the therapeutic effects of malignant pleural effusion were compared,the levels of serum tumor markers in the two groups were detected and compared,and VEGF levels and KPS scores in pleural effusion were compared.Adverse reactions of the two groups were statistically analyzed.Results The treatment effect of malignant pleural effusion in the treatment group was significantly higher than that in the control group,and the difference between the two groups was significant(P < 0.05).Compared with that before treatment,serum CK-19,TSGF and CEA levels of the two groups were significantly decreased after treatment,with the treatment group significantly lower than those of the control group(P < 0.05),the KPS score of the two groups was significantly increased after treatment,with the treatment group significantly higher than the control group(P < 0.05),and the level of VEGF in pleural effusion was significantly lower,with the treatment group significantly lower than the control group(P < 0.05).There was no significant difference in the incidence of adverse reactions between the two groups during the treatment period(P > 0.05).Conclusion Bevacizumab combined with chemotherapy can significantly improve their clinical symptoms in the treatment of lung adenocarcinoma patients with good efficacy and safety.
Objective To investigate the efficacy and safety of bevacizumab combined with chemotherapy for malignant pleural effusion in patients with lung adenocarcinoma.Methods 92 cases of lung adenocarcinoma patients hospitalized were selected as the study subjects,and were divided into treatment group(n = 46) and control group(n =46) according to the random number table method.Patients in the control group were only given chemotherapy,and patients in the treatment group were treated with bevacizumab based on the treatment of patients in the control group.Between two groups,the therapeutic effects of malignant pleural effusion were compared,the levels of serum tumor markers in the two groups were detected and compared,and VEGF levels and KPS scores in pleural effusion were compared.Adverse reactions of the two groups were statistically analyzed.Results The treatment effect of malignant pleural effusion in the treatment group was significantly higher than that in the control group,and the difference between the two groups was significant(P < 0.05).Compared with that before treatment,serum CK-19,TSGF and CEA levels of the two groups were significantly decreased after treatment,with the treatment group significantly lower than those of the control group(P < 0.05),the KPS score of the two groups was significantly increased after treatment,with the treatment group significantly higher than the control group(P < 0.05),and the level of VEGF in pleural effusion was significantly lower,with the treatment group significantly lower than the control group(P < 0.05).There was no significant difference in the incidence of adverse reactions between the two groups during the treatment period(P > 0.05).Conclusion Bevacizumab combined with chemotherapy can significantly improve their clinical symptoms in the treatment of lung adenocarcinoma patients with good efficacy and safety.
引文
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[18]潘绵顺,李勇,邱书珺,等.SRT联合贝伐珠单抗治疗肺腺癌脑转移瘤的疗效评估[J].中华放射肿瘤学杂志,2017,26(8):880-883.
[19]吴申,周强,周春苗,等.贝伐珠单抗联合化疗治疗晚期肺腺癌[J].中国新药与临床杂志,2015,34(3):221-225.
[2]LABBE C,ANDERSON M,SIMARD S,et al.Wait times for diagnosis and treatment of lung cancer:a single centre experience[J].Curr Oncol,2016,24(6):367.
[3]马会芳,陆士新,张伟杰,等.恩度/贝伐单抗联合紫杉醇加铂类治疗晚期肺腺癌近期疗效对比观察[J].肿瘤防治研究,2015,42(1):62-64.
[4]唐纯丽,陈小波,谢佳星,等.小剂量贝伐珠单抗联合培美曲赛治疗Ⅳ期EGFR突变阴性肺腺癌的有效性和安全性研究[J].新医学,2016,47(2):109-112.
[5]中国华人民共和国卫生部.中国常见恶性肿瘤诊治规范[M].北京:北京医科大学、中国协和医科大学联合出版社,1991:80-90.
[6]TAN D S,YOM S S,TSAO M S,et al.The international association for the study of lung cancer consensus statement on optimizing management of EGFR mutation-positive non-small cell lung cancer:status in 2016[J].JTO,2016,11(7):946-963.
[7]SHI Y,LI J,ZHANG S,et al.Molecular epidemiology of EGFR mutations in Asian patients with advanced nonsmall-cell lung cancer of adenocarcinoma histology-mainland China subset analysis of the PIONEER study[J/OL].Plos One,2015,10(11):e0143515[2018-11-01].https://www.ncbi.nlm.nih.gov/pubmed/26599344.DOI:10.1371/journal.pone.0143515.
[8]熊志成,刘洋,孙鑫,等.奥希替尼联合贝伐珠单抗治疗伴EGFR T790M突变肺腺癌的疗效与机制研究[J].中国肿瘤临床,2017,44(15):744-749.
[9]CHEN W,ZHENG R,ZENG H,et al.Epidemiology of lung cancer in China[J].Thorac Cancer,2015,6(2):209-215.
[10]齐晓光,祁春艳,秦博宇,等.贝伐珠单抗联合厄洛替尼治疗突变阳性肺腺癌1例[J].河北医药,2016,8(3):477-478.
[11]AHRENDT S A,DECKER P A,ALAWI E A,et al.Cigarette smoking is strongly associated with mutation of the K-ras gene in patients with primary adenocarcinoma of the lung[J].Cancer,2015,92(6):1525-1530.
[12]黄芳,姜达,李颖,等.晚期肺腺癌化疗方案的优化[J].肿瘤防治研究,2015,42(7):687-692.
[13]STELLMAN S D,MUSCAT J E,THOMPSON S,et al.Risk of squamous cell carcinoma and adenocarcinoma of the lung in relation to lifetime filter cigarette smoking[J].Cancer,2015,80(3):382-388.
[14]ISLAMI F,TORRE L A,JEMAL A.Global trends of lung cancer mortality and smoking prevalence[J].Transl Cancer Res,2015,4(4):327.
[15]NEUGUT A I,MURRAY T,SANTOS J,et al.Increased risk of lung cancer after breast cancer radiation therapy in cigarette smokers[J].Cancer,2015,73(6):1615-1620.
[16]HONG Q,WU G M,QIAN G,et al.Prevention and management of lung cancer in China[J].Cancer,2015,121(S17):3080-3088.
[17]张松亮,徐鹏飞,袁成,等.贝伐珠单抗联合培美曲塞加卡铂新辅助化疗方案对Ⅲa期肺腺癌手术安全性的影响[J].中国肺癌杂志,2015,18(6):365-368.
[18]潘绵顺,李勇,邱书珺,等.SRT联合贝伐珠单抗治疗肺腺癌脑转移瘤的疗效评估[J].中华放射肿瘤学杂志,2017,26(8):880-883.
[19]吴申,周强,周春苗,等.贝伐珠单抗联合化疗治疗晚期肺腺癌[J].中国新药与临床杂志,2015,34(3):221-225.