吉非替尼联合沙利度胺治疗非小细胞肺癌的临床疗效分析

Clinical Efficacy of Gefitinib Combined with Thalidomide in the Treatment of Non-small Cell Lung Cancer

关键词:  吉非替尼  沙利度胺  非小细胞肺癌  近期疗效  生存质量  肿瘤标志物

Key words:  gefitinib  thalidomide  non-small cell lung cancer  short-term efficacy  quality of life  tumor markers

摘要:

目的 探讨吉非替尼联合沙利度胺对非小细胞肺癌患者近期疗效、生存质量及血清肿瘤标志物的影响。方法 选取淄博市第四人民医院2015年3月—2017年3月期间收治的晚期非小细胞肺癌患者98例，按照随机表法分为观察组49例与对照组49例。2组患者均采用DP化疗方案。对照组采用沙利度胺片，观察组在对照组基础上联用吉非替尼。2组均以28 d为1个周期，连续4个周期。比较2组近期疗效、生存质量改善情况，治疗前后血清肿瘤标志物水平变化，及不良反应发生情况。结果 观察组近期总有效率（75.51%）显著高于对照组（55.10%）（P<0.05）。观察组生存质量提高率（79.59%）显著高于对照组（59.18%）（P<0.05）。与治疗前比较，2组治疗后血清CA125、CEA和CYFRA21-1水平降低（P<0.05）；观察组治疗后血清CA125、CEA和CYFRA21-1水平低于对照组（P<0.05）。2组白细胞减少、血小板减少、恶心呕吐、乏力、肝功能损害及腹泻发生率比较无统计学意义。结论 吉非替尼联合沙利度胺对非小细胞肺癌患者近期疗效显著，可提高患者生存质量，降低血清CA125、CEA和CYFRA21-1水平。

Abstract:

OBJECTIVE To investigate the effect of gefitinib combined with thalidomide on the short-term efficacy, quality of life and serum tumor markers in patients with non-small cell lung cancer. METHODS Ninety-eight patients with advanced non-small cell lung cancer who were treated in the Fourth People's Hospital of Zibo City from March 2015 to March 2017 were collected and randomly divided into the observation group(49 cases) and the control group(49 cases). Two groups of patients were treated with DP chemotherapy program. The control group was treated with thalidomide, and the observation group was treated with gefitinib on the basis of the control group. The two groups were treated with 28 d for one cycle, 4 consecutive cycles. The short-term efficacy, improvement of quality of life, improvement of serum tumor markers and adverse reactions were compared between the two groups. RESULTS The total effective rate in the observation group(75.51%) was higher than that in the control group(55.10%)(P<0.05). The improvement rate of quality of life in observation group(79.59%) was higher than that in control group(59.18%)(P<0.05). Serum CA125, CEA and CYFRA21-1 levels decreased in two groups after treatment(P<0.05); the serum CA125, CEA and CYFRA21-1 levels after treatment in the observation group were lower than that in the control group(P<0.05). There was no significant difference in the incidence of leukopenia, thrombocytopenia, nausea, vomiting, fatigue, liver function damage and diarrhea between the two groups. CONCLUSION Gefitinib combined with thalidomide in the treatment of patients with non-small cell lung cancer have significant curative effect, can improve the survival of patients after treatment, can reduce the level of serum CA125, CEA and CYFRA21-1.