摘要
目的探究安罗替尼治疗晚期非小细胞肺癌(NSCLC)的近期疗效及对外周血循环肿瘤细胞(CTC)和血管内皮生长因子(VEGF)水平、生存质量的影响。方法前瞻性选取2018年10月至2019年10月期间在连云港东方医院接受三线或以上治疗的晚期NSCLC患者120例,按随机数表法分为实验组和对照组,每组60例。实验组服用安罗替尼进行治疗,对照组根据患者情况进行常规单药化疗。观察比较2组患者的近期治疗效果[客观缓解率(ORR)、疾病控制率(DCR)],于治疗前和治疗3个疗程后观察2组患者的外周血CTC、VEGF水平、生活质量核心问卷QLQ-C30和肺癌专项量表QLQ-LC13评分变化,利用Kaplan-Miere生存曲线法分析患者的生存率情况,并记录治疗期间2组患者发生不良反应的情况。结果实验组的DCR为88.33%,明显高于对照组的71.67%(P<0.05);实验组的ORR为46.67%明显高于对照组的28.33%(P<0.05)。治疗3个周期后,实验组患者的的CTC阳性率和VGEF的水平均显著低于治疗前(P<0.05),对照组患者治疗后的VGEF的水平显著低于治疗前(P<0.05);治疗后实验组患者的CTC阳性率和VGEF的水平均显著低于对照组(P<0.05)。治疗3个周期后,实验组的躯体功能、角色功能、情绪功能、社会功能、总体健康情况、疲乏、疼痛、恶心呕吐、失眠、口腔疼痛、吞咽困难、手足刺痛、脱发、胸痛、手或肩部疼痛方面均明显优于对照组(P<0.05)。Kaplan-Miere分析显示实验组的存活率为60.00%,高于对照组50.00%(P<0.05)。实验组与对照组的不良反应总发生率比较(48.33%vs.46.67%),差异无统计学意义(P>0.05)。结论安罗替尼治疗晚期NSCLC的近期疗效优于单药化疗,并能有效降低CTC和VGEF的水平,且生存质量优于单药化疗,相对于继续单药化疗,不良反应可耐受。
Objective To explore the short-term curative effect of anlotinib on advanced non-small cell lung cancer(NSCLC)and its influences on levels of circulating tumor cells(CTC)and vascular endothelial growth factor(VEGF)in peripheral blood and quality of life.Methods A total of 120 patients with advanced NSCLC who underwent third-line or above treatment in Lianyungang Oriental Hospital from October 2018 to October 2019 were enrolled.They were divided into experimental group and control group by random number table method,60 cases in each group.The experimental group was treated with anlotinib,while control group underwent routine monotherapy according to patients'conditions.The short-term curative effect[objective response rate(ORR),disease control rate(DCR)]was observed and compared between the two groups.The changes in peripheral blood CTC and VGEF levels,as well as scores of Quality of Life-Core 30 Questionnaire(QLQ-C30)and Quality of Life-Lung Cancer 13 Questionnaire(QLQ-LC13)before treatment and after 3 courses of treatment in both groups were observed.The survival rates of patients were analyzed by Kaplan-Miere survival curves.And adverse reactions during treatment in both groups were recorded.Results DCR of experimental group was significantly higher than that of control group(88.33%vs.71.67%)(P<0.05),and ORR was significantly higher than that of control group(46.67%vs.28.33%)(P<0.05).After 3 courses of treatment,positive rate of CTC and level of VGEF in experimental group were significantly decreased(P<0.05),and level of VGEF in control group was significantly decreased(P<0.05).After 3 courses of treatment,positive rate of CTC and level of VGEF in experimental group were significantly lower than those in control group(P<0.05).The physical function,role function,emotional function,social function,overall health,fatigue,pain,nausea and vomiting,insomnia,oral pain,dysphagia,hand and foot tingling,hair loss,chest pain,hand or shoulder pain in experimental group were significantly better than those in control group(P<0.05).Kaplan-Miere analysis showed that the survival rate in experimental group was significantly higher than that in control group(60.00%vs.50.00%,P<0.05).In terms of the occurrence of adverse reactions,there was no significant difference in total incidence of adverse reactions between experimental group and control group(48.33%vs.46.67%,P>0.05).Conclusion The short-term curative effect of anlotinib is better than that of monotherapy on advanced NSCLC.Anlotinib can effectively reduce the levels of VGE and CTC,and the quality of life is better than that of monotherapy.Compared with continued monotherapy,the adverse reactions are tolerable.
作者
冯媛媛
姚凤龙
王卫东
郭加友
朱正秋
FENG Yuan-yuan;YAO Feng-long;WANG Wei-dong(Department of Oncology,Lianyungang Oriental Hospital,Lianyungang Jiangsu 222042,China)
出处
《临床和实验医学杂志》
2020年第22期2399-2403,共5页
Journal of Clinical and Experimental Medicine
基金
江苏省卫生厅课题项目课题(编号:J201802)。
关键词
非小细胞肺癌
安罗替尼
血管内皮生长因子
生存质量
Non-small cell lung cancer
Anlotinib
Vascular endothelial growth factor
Quality of life
