[1]丁 锋,张清会.厄洛替尼联合紫杉醇和顺铂治疗晚期非小细胞肺癌疗效观察[J].新乡医学院学报,2018,35(6):513-516.[doi:10.7683/xxyxyxb.2018.06.016]
 DING Feng,ZHANG Qing-hui.Effect of erlotinib combined with paclitaxel and cisplatin in treatment of advanced non-small cell lung cancer[J].Journal of Xinxiang Medical University,2018,35(6):513-516.[doi:10.7683/xxyxyxb.2018.06.016]
点击复制

厄洛替尼联合紫杉醇和顺铂治疗晚期非小细胞肺癌疗效观察
分享到:

《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
35
期数:
2018年6
页码:
513-516
栏目:
临床研究
出版日期:
2018-06-05

文章信息/Info

Title:
Effect of erlotinib combined with paclitaxel and cisplatin in treatment of advanced non-small cell lung cancer
作者:
丁 锋1张清会2
(1.南阳医学高等专科学校第一附属医院呼吸与危重医学科,河南 南阳 473000;2.南阳医学高等专科学校第一附属医院干部病房,河南 南阳 473000)
Author(s):
DING Feng1ZHANG Qing-hui2
(1.Department of Respiratory Disease and Critical Care Medicine,the First Affiliated Hospital of Nanyang Medical College,Nanyang 473000,Henan Province,China;2.Department of Cadre Ward,the First Affiliated Hospital of Nanyang Medical College,Nanyang 473000,Henan Province,China)
关键词:
非小细胞肺癌厄洛替尼紫杉醇顺铂生存率
Keywords:
non-small cell lung cancererlotinibpaclitaxelcisplatinsurvival rate
分类号:
R734.2
DOI:
10.7683/xxyxyxb.2018.06.016
文献标志码:
A
摘要:
目的 探讨厄洛替尼、紫杉醇和顺铂联合治疗晚期非小细胞肺癌(NSCLC)的临床效果。方法 选择2014年4月至2015年4月南阳医学高等专科学校第一附属医院收治的TNM Ⅲ~Ⅳ期NSCLC患者200例为研究对象,根据化学治疗方法分为观察组和对照组,每组100例。对照组患者给予紫杉醇和顺铂联合化学治疗,观察组患者给予厄洛替尼、紫杉醇和顺铂联合化学治疗。分别于化学治疗前和化学治疗2个周期后检测2组患者血清癌胚抗原(CEA)、糖类抗原125(CA125)、糖类抗原199(CA199)和细胞角蛋白19片段(CYFRA211)水平;观察2组患者治疗期间的不良反应;化学治疗2个周期后,按照世界卫生组织制定的实体瘤疗效评价标准进行疗效评估;2组患者随访 2 a,统计患者生存率。结果 2组患者治疗前血清CEA、CA125、CA199及CYFRA211水平比较差异均无统计学意义(P>0.05),2组患者治疗后血清CEA、CA125、CA199及CYFRA211水平显著低于治疗前(P<0.05),治疗后观察组患者血清CEA、CA125、CA199及CYFRA211水平显著低于对照组(P<0.05)。观察组和对照组患者治疗总有效率分别为74.0%(74/100)、57.0%(57/100),观察组患者治疗总有效率显著高于对照组(χ2=6.395,P<0.05)。观察组和对照组患者化学治疗过程中不良反应发生率分别为45.0%(45/100)、78.0%(78/100);观察组患者不良反应发生率显著低于对照组(χ2=22.997,P<0.05)。观察组和对照组患者2 a生存率分别为90.0%(90/100)、75.0%(75/100),观察组患者2 a生存率显著高于对照组(χ2=8.028,P<0.05)。结论 厄洛替尼、紫杉醇和顺铂联合治疗方案可显著降低晚期NSCLC患者血清肿瘤标志物水平,提高治疗效果和生存率,降低化学治疗相关的不良反应发生率。
Abstract:
Objective To investigate the clinical effect of erlotinib combined with paclitaxel and cisplatin in the treatment of advanced non-small cell lung cancer(NSCLC).Methods A total of 200 patients with stage TNM Ⅲ-Ⅳ NSCLC in the First Affiliated Hospital of Nanyang Medical College from April 2014 and April 2015 were selected as the subjects.The patients were divided into observation group and control group according to the chemotherapy,100 cases in each group.The patients in the control group were treated with combined chemotherapy of paclitaxel and cisplatin.The patients in the observation group were treated with combined chemotherapy of erlotinib,paclitaxel and cisplatin.The levels of serum carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125),carbohydrate antigen 199(CA199) and cytokeratin 19 fragment(CYFRA211) of the patients in the two groups were detected before and after two cycles of chemotherapy.The adverse reactions of the patients in the two groups were observed during the treatment.The curative effect was evaluated according to the response evaluation criteria in solid tumors formulated by World Health Organization.The patients in the two groups were followed up for two years,and the survival rate of the patients was statistically analyzed.Results There was no significant difference in serum CEA,CA125,CA199 and CYFRA211 levels between the two groups before treatment(P>0.05).The levels of serum CEA,CA125,CA199 and CYFRA211 after treatment were significantly lower than those before treatment in the two groups(P<0.05).The levels of serum CEA,CA125,CA199 and CYFRA211 in the observation group were significantly lower than those in the control group after treatment(P<0.05).The total effective rate in the observation group and the control group was 74.0%(74/100) and 57.0%(57/100) respectively,the total effective rate in the observation group was significantly higher than that in the control group(χ2=6.395,P<0.05).The incidence of adverse reactions in the observation group and the control group was 45.0%(45/100) and 78.0%(78/100) respectively,the incidence of adverse reactions in the observation group was significantly lower than that in the control group(χ2=22.997,P<0.05).The 2-year survival rate in the observation group and the control group was 90.0%(90/100) and 75.0%(75/100) respectively,the 2-year survival rate in the observation group was significantly higher than that in the control group(χ2=8.028,P<0.05).Conclusion The combined chemotherapy of erlotinib,paclitaxel and cisplatin can significantly reduce the levels of serum tumor markers,improve the therapeutic effect and survival rate,and reduce the incidence of chemical therapy related adverse reactions in patients with advanced NSCLC.

参考文献/References:

[1] 薄聪.EGFR敏感突变肺鳞状细胞癌13例分析并文献回顾[D].济南:山东大学,2016.
[2] 宋士军,赵红丹.射频消融术治疗非小细胞肺癌近期疗效观察[J].新乡医学院学报,2016,33(8):718-720.
[3] 宋勇,高健伟.精准医学时代的晚期非小细胞肺癌内科治疗进展[J].医学研究生学报,2017,30(11):1121-1127.
[4] 王正,赵瑞峰,王娟,等.18F-FDG PET-CT及实体瘤疗效评价标准评价肺癌早期化疗效果的临床研究[J].肿瘤研究与临床,2015,27(7):488-490.
[5] EISENHAUER E A,THERASSE P,BOGAERTS J,et al.New response evaluation criteria in solid tumours:revised RECIST guideline(version 1.1)[J].Eur J Cancer,2009,45(2):228-247.
[6] 世界卫生组织.抗癌药急性及亚急性毒性反应分度标准(WHO标准)[J].癌症,1992,11(3):254.
[7] MITSUDOMI T,MORITA S,YATABE Y,et al.Gefitinib versus cisplatin plus docetaxel in patients with non-small-cell lung cancer harbouring mutations of the epidermal growth factor receptor(WJTOG3405):an open label,randomised phase 3 trial[J].Lancet Oncol,2010,11(2):121-128.
[8] 王如菊,许佩佩,欧阳建.生物药物载体在肿瘤治疗中的研究进展[J].东南大学学报,2015,34(4):623-628.
[9] 陶峰.香菇多糖联合化学治疗对中晚期非小细胞肺癌的临床效果[J].实用医技杂志,2017,24(9):1012-1013.
[10] 蒋涛,周彩存.ALK阳性非小细胞肺癌患者克唑替尼耐药的机制和治疗措施[J].中国肺癌杂志,2015,18(2):69-74.
[11] 李昭,李劫.靶向药物厄洛替尼的研究进展[J].医学临床研究,2014,31(9):1846-1848.
[12] 熊雯,周新娥,黄娟,等.血清CA125、HE4及IL-17检测对上皮性卵巢癌的早期诊断价值分析[J].中国计划生育和妇产科,2016,8(3):69-73.
[13] SUBRAMANIAN J,GOVINDAN R.Molecular profile of lung cancer in never smokers[J].Ejc Suppl,2013,11(2):248-253.

相似文献/References:

[1]张开普.介入治疗局部晚期非小细胞肺癌42例[J].新乡医学院学报,2002,19(05):421.
[2]牛红蕊,袁 亮,吴随群.羟基喜树碱联合顺铂和足叶乙甙治疗中晚期非小细胞肺癌39例[J].新乡医学院学报,2002,19(05):419.
[3]赫鸿昌.异长春花碱联合顺铂治疗晚期非小细胞肺癌l7例[J].新乡医学院学报,2003,20(02):126.
[4]赫鸿昌.异长春花碱联合顺铂治疗晚期非小细胞肺癌17 例[J].新乡医学院学报,2003,20(02):126.
[5]张海君,闫卫东,邝先奎.目的从伦理学的角度来思考基因歧视产生的原因和所引起的危害,并寻求对策。方法查阅并分析近1O年的文献。结果导致基因歧视产生的理论观点是不正确的,这种现象对人类有极大的危害,人们可以通过对隐私权的保护来避免或减轻它对人类的伤害。结论 基因歧视是不公正也是不[J].新乡医学院学报,2003,20(06):428.
[6]杨廷桐,李秀杰,武俊芳,等.端粒酶反转录酶活化与p53金属蛋白酶-9表达对非小细胞肺癌发生的影响[J].新乡医学院学报,2007,24(05):000.
[7]杨廷桐,武俊芳,李秀杰,等.非小细胞肺癌中p14ARF和mtp53蛋白表达与临床病理参数的关系[J].新乡医学院学报,2008,25(04):336.
[8]姬明丽,千智斌,徐自超.p53蛋白与非小细胞肺癌多药耐药性的关系[J].新乡医学院学报,2008,25(01):013.
[9]孙秀威,陈玉玲,黄鹏.非小细胞肺癌中核糖核苷酸还原酶亚单位M1 表达及其与吉西他滨化学治疗敏感性相关研究[J].新乡医学院学报,2011,28(02):157.
[10]郑翠侠,韩兵,周翔,等.非小细胞肺癌中表皮生长因子受体基因突变的筛查[J].新乡医学院学报,2011,28(02):190.

更新日期/Last Update: 2018-06-05