摘要
目的观察阿帕替尼用于三线及以上治疗Ⅲ～Ⅳ期非小细胞肺癌(non-small cell lung cancer,NSCLC)的临床效果及对血清肿瘤标志物的影响。方法回顾郑州大学第一附属医院2015年3月至2018年2月收治的66例三线及以上治疗使用阿帕替尼或多西他赛联合吉西他滨的晚期NSCLC患者的临床资料,其中35例三线及以上治疗使用阿帕替尼者作为观察组,使用多西他赛联合吉西他滨者31例作为对照组。比较两组临床疗效,中位无进展生存期(mPFS),治疗前后血清肿瘤标志物癌胚抗原(CEA)、细胞角蛋白19片段(CYERA21-1)水平及不良反应发生情况。结果观察组mPFS长于对照组(94 d比67 d,P=0.020),疾病控制率(DCR)高于对照组(68.6%比38.7%,P=0.015);观察组客观缓解率(ORR)为22.9%(8/35),对照组为16.1%(5/31),组间差异无统计学意义(P>0.05)。治疗后观察组CEA和CYERA21-1均较对照组下降,差异有统计学意义(P<0.05)。观察组3～4级不良反应发生率为17.1%(6/35),对照组为19.4%(6/31),组间差异无统计学意义(P>0.05)。结论阿帕替尼治疗晚期非小细胞肺癌患者临床效果显著,不良反应可控,能够降低肿瘤标志物CEA、CYERA21-1水平。
Objective To observe the clinical efficacy of apatinib in the treatment of stageⅢ-Ⅳnon-small cell lung cancer after failure of second-line chemotherapy and its influence on serum tumor markets.Methods Clinical data of 66 patients with advanced NSCLC admitted to the First Affiliated Hospital of Zhengzhou University from March 2015 to February 2018 were selected.The observation group(n=35)were treated with apatinib and the control group were treated with docetaxel combined with gemcitabine.The clinical efficacy,mPFS,the levels of serum tumor markers such as carcinoembryonic antigen(CEA),cytokeratin 19 fragment(CYERA21-1)and adverse reactions were compared between before and after treatment.Results The mPFS and DCR in observation group were significantly higher than those in control group(94 days vs.67 days,P=0.020;68.6%vs.38.7%,P=0.015).The ORR of control group was 16.1%(5/31),the ORR of observation group was 22.9%(8/35),and the difference was not statistically significant(P>0.05).The levels of CEA and CYERA21-1 in the observation group were lower than those in the control group after treatment,and the difference was statistically significant(P<0.05).The incidence of adverse events in grades 3-4 of observation group was 17.1%(6/35),the incidence of adverse events in grades 3-4 of control group was 19.4%(6/31),and the difference was not statistically significant(P=0.816).Conclusion Apatinib have significant clinical efficacy in the treatment of advanced non-small cell lung cancer with controllable adverse reactions,which can reduce the levels of tumor makers CEA and CYERA21-1.
作者
郎梦真
李洁瑶
岳冬丽
沈梦杰
王文哲
王丽萍
LANG Meng-zhen;LI Jie-yao;YUE Dong-li;SHEN Meng-jie;WANG Wen-zhe;WANG Li-ping(Department of Oncology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《河南医学研究》
CAS
2019年第5期785-789,共5页
Henan Medical Research
基金
国家自然科学基金(81872410)
关键词
阿帕替尼
非小细胞肺癌
晚期肺癌
癌胚抗原
细胞角蛋白19片段
apatinib
non-small cell lung cancer
advanced lung cancer
carcinoembryonic antigen
cytokeratin 19 fragment
