摘要
目的探究奥希替尼联合培美曲塞/铂类对EGFR合并TP53突变的非小细胞肺癌(NSCLC)疗效及预后分析。方法选取中国人民解放军联勤保障部队第904医院在2016年1月至2022年6月间诊治的80例表皮生长因子受体合并TP53基因突变的NSCLC患者纳入本次研究,随机数字法分为对照组(40例)和研究组(40例)。对照组行奥希替尼治疗,研究组行奥希替尼联合培美曲塞/铂类化疗治疗。对两组临床疗效、血清指标水平、用药安全性以及预后进行对比分析。结果研究组总缓解率(ORR)和疾病控制率(DCR)均优于对照组(P<0.05)。治疗后,两组细胞角蛋白19片段(CYFRA21-1)、癌胚抗原(CEA)水平均低于治疗前(P<0.05),研究组低于对照组(P<0.05)。治疗后,两组白细胞介素4(IL-4)、血管内皮生长因子(VEGF)、细胞间黏附分子-1(ICAM-1)水平均低于治疗前(P<0.05),研究组低于对照组(P<0.05)。两组不良反应差异无统计学意义(P>0.05)。研究组随访1年后的生存率明显高于对照组(P<0.05)。治疗后,两组生存质量测定表(EORTC QLQ-C30)评分高于治疗前(P<0.05),研究组高于对照组(P<0.05)。结论奥希替尼联合培美曲塞/铂类化疗方案用于EGFR合并TP53基因突变的NSCLC的临床治疗,可有效发挥抗肿瘤效果,下调炎症水平,提升疗效,改善患者预后,且用药具有较高安全性,不会明显增加不良反应。
Objective To explore the efficacy and prognostic analysis of osimertinib combined with pemetrexed/platinum in non-small cell lung cancer(NSCLC)with EGFR and TP53 mutations.Methods Eighty patients with NSCLC with EGFR and TP53 mutations,who were diagnosed in 904th Hospital of Joint Logistics Support Force between January 2016 and June 2022,were randomly selected for this study.They were randomly divided into a control(40 patients)group and a study(40 patients)group.The control group received Osimertinib treatment,while the study group received pemetrexed/platinum combined with osimertinib treatment.The clinical efficacy,serum indicator levels,medication safety,and prognosis of the two groups were compared.Results The overall response rate(ORR)and disease control rate(DCR)of the study group were significantly better than those of the control group(P<0.05).After treatment,the levels of cytokeratin 19 fragment(CYFRA21-1),and carcinoembryonic antigen(CEA)were significantly lower in both groups than before treatment(P<0.05),and they were significantly lower in the study group than in the control group(P<0.05).After treatment,the levels of interleukin 4(IL-4),vascular endothelial growth factor(VEGF),and intercellular adhesion molecule-1(ICAM-1)were significantly lower in both groups than before treatment(P<0.05),and they were significantly lower in the study group than in the control group(P<0.05).There was no statistically significant difference in adverse effects between the two groups(P>0.05).The survival rate of the study group after 1 year of follow-up was significantly higher than that of the control group(P<0.05).After treatment,the EORTC QLQ-C30 score of the two groups was higher than before treatment(P<0.05),and the score of the study group was higher than that of the control group(P<0.05).Conclusions Osimertinib combined with pemetrexed/platinum based chemotherapy regimen is used in the clinical treatment of NSCLC with EGFR and TP53 mutations,which can effectively exert antitumor effects,downgrade the level of inflammation,enhance the efficacy,and improve patient prognosis.And the medication has a high safety and does not significantly increase adverse reactions.
作者
王伟
周伟
WANG Wei;ZHOU Wei(Department of Medical Oncology,904th Hospital of Joint Logistics Support Force,Wuxi 350025,China)
出处
《中国肿瘤外科杂志》
CAS
2024年第2期143-147,共5页
Chinese Journal of Surgical Oncology
基金
江苏省研究生科研与实践创新计划项目(SJCX21_1152)。
