摘要
目的探讨非小细胞肺癌(NSCLC)应用重组改构人肿瘤坏死因子(rmhTNF)雾化吸入联合化疗的临床效果。方法将118例NSCLC患者按随机数字表法分为观察组(n=59)和对照组(n=59)。对照组予以吉西他滨+卡铂(GP)化疗方案治疗,观察组在此基础上联合rmhTNF雾化吸入治疗,所有患者均治疗4个化疗周期。对比两组患者临床疗效,治疗前后血清相关肿瘤标志物[糖类抗原15-3(CA15-3)、癌胚抗原(CEA)、糖类抗原125(CA125)]水平、外周血中调节性T细胞(Treg)和辅助性T细胞(Th)17水平、癌症治疗性功能评价量表-肺癌(FACT-L)评分变化以及不良反应发生情况。结果观察组患者的ORR、CBR分别为52.5%(31/59)、81.4%(48/59),均高于对照组的33.9%(20/59)、64.4%(38/59),差异均有统计学意义(P﹤0.05)。治疗前,两组患者CA15-3、CEA、CA125、Treg、Th17、Treg/Th17水平及FACT-L中各领域(生理状况、情感状况、社会/家庭状况、功能状况、肺癌附加的关注)评分及总分比较,差异均无统计学意义(P﹥0.05);治疗后,两组患者CA15-3、CEA、CA125、Treg、Th17、Treg/Th17水平均较治疗前下降,生理状况、情感状况、社会/家庭状况、功能状况、肺癌附加的关注评分及总分均较治疗前上升,且观察组患者CA15-3、CEA、CA125、Treg、Th17、Treg/Th17水平均低于对照组,生理状况、情感状况、社会/家庭状况、功能状况、肺癌附加的关注评分及总分均高于对照组,差异均有统计学意义(P﹤0.05)。两组患者消化道反应、骨髓抑制、肝肾功能损害、过敏反应、口腔溃疡不良反应发生情况比较,差异均无统计学意义(P﹥0.05)。结论NSCLC应用rmhTNF雾化吸入联合化疗可有效稳定患者病情,维持体内Treg/Th17稳态,改善生活质量,疗效确切,且患者耐受性良好。
Objective To explore the clinical efficacy of combined therapy of aerosol inhalation of recombinant mutant human tumor necrosis factor(rmhTNF)and chemotherapy in the treatment of non-small cell lung cancer(NSCLC).Method Totally,118 patients with NSCLC were included in the analysis and randomized into study group(n=59)and control group(n=59)using a random number table.The control group was treated with chemotherapy regimen of gemcitabine plus carboplatin(GP),while the study group patients were administered with aerosol inhalation of rmhTNF in addition to the chemotherapy for control group.All patients were treated for 4 cycles.The clinical efficacy of two groups were compared,the changes of serum tumor marker[carbohydrate antigen(CA)15-3,carcinoembryonic antigen(CEA),CA125]concentration,levels of regulatory T cell(Treg)and helper T cell(Th)17 as well as Functional Assessment for Cancer Therapy-Lung(FACT-L)scores before and after treatment were assessed,and occurrence of adverse reactions were compared between the two groups.Result The overall response rate(ORR)and clinical benefit rate(CBR)in study group was 52.5%(31/59)and 81.4%(48/59),which were higher than those of the control group at 33.9%(20/59)and 64.4%(38/59),respectively(P<0.05).Before treatment,there was no significant difference in regard of CA15-3,CEA,CA125,Treg,Th17,Treg/Th17 levels,and subscores and total score in all domains of FACT-L(physiological,emotional,social/family,functional well-being,and additional concerns)between the two groups(P>0.05).After treatment,the levels of CA15-3,CEA,CA125,Treg,Th17,Treg/Th17 in the two groups were decreased,besides the subscores of physiological,emotional,social/family,functional well-being,additional concerns and total score were improved,furthermore,the changes in study group were greater compared to control group for CA15-3,CEA,CA125,Treg,Th17,Treg/Th17 levels,as well as the subscores and total score of physiological,emotional,social/family,functional well-being and additional concerns(P<0.05).No evident differences were noted with respect to gastrointestinal reactions,bone marrow suppression,hepatic and renal dysfunction,allergy,and oral ulcer between the two groups(P>0.05).Conclusion In the treatment of NSCLC,the application of combined therapy of aerosol inhalation of rmhTNF may effectively stabilize patients’condition,maintaining Treg/Th17 homeostasis and thus improves their quality of life,with pronounced efficacy and acceptable profile for tolerance.
作者
江泷
何健行
JIANG Long;HE Jianxing(Department of Thoracic Surgery,the First Affiliated Hospital of Guangzhou Medical University,Guangzhou 510120,Guangdong,China)
出处
《癌症进展》
2020年第14期1477-1481,共5页
Oncology Progress
