西黄丸联合免疫及EC化疗一线治疗广泛期小细胞肺癌的临床效果及安全性

Clinical efficacy and safety of Xihuang Pills combined with immunotherapy and EC chemotherapy in first-line treatment of extensive small cell lung cancer

目的探讨西黄丸联合免疫及EC化疗一线治疗广泛期小细胞肺癌的临床效果及安全性。方法选取2021年8月至2023年2月江西省胸科医院收治的126例广泛期小细胞肺癌患者作为研究对象,按照随机信封法分为研究组和对照组,每组63例。对照组患者采用免疫及EC化疗,研究组在对照组的基础上联用西黄丸,比较两组患者的临床疗效、血钠浓度、胃泌素释放肽前体(proGRP)、肿瘤标志物、生存质量、不良反应发生情况。结果研究组治疗客观缓解率(ORR)高于对照组,差异有统计学意义(P<0.05)。治疗结束后7 d,两组患者肿瘤卡氏评分(KPS)高于本组治疗前,且研究组KPS评分高于对照组,差异有统计学意义(P<0.05)。研究组无进展生存期(PFS)高于对照组,差异有统计学意义(P<0.05)。治疗结束后7 d,两组患者血钠浓度高于本组治疗前,proGRP、癌胚抗原(CEA)、神经元烯醇化酶(NSE)和糖类抗原125(CA125)水平低于本组治疗前,且研究组血钠浓度高于对照组,proGRP、CEA、NSE和CA125水平低于对照组,差异有统计学意义(P<0.05)。研究组不良反应总发生率低于对照组,差异有统计学意义(P<0.05)。结论西黄丸联合免疫及EC化疗方案治疗广泛期小细胞肺癌有效率高,能够延缓肿瘤进展,降低肿瘤标志物表达水平,改善生存质量,治疗安全性和实用性较高。

Objective To investigate the clinical efficacy and safety of Xihuang Pills combined with immunotherapy and EC chemotherapy in the first-line treatment of extensive small cell lung cancer.Methods A total of 126 patients with extensive small cell lung cancer treated in Jiangxi Chest Hospital from August 2021 to February 2023 were selected as the research objects,and they were divided into research group and control group according to random envelope method,with 63 cases in each group.The control group was treated with immunotherapy and EC chemotherapy,and the research group was combined with Xihuang Pills on the basis of the control group.The clinical efficacy,blood sodium concentration,pro-gastrin-releasing peptide(proGRP),tumor markers,quality of life and the occurrence of adverse reactions of the two groups were compared.Results The objective response rate(ORR)in the research group was higher than that in the control group,the difference was statistically significant(P<0.05).Seven days after the end of treatment,the tumor Karnofsky performance scale(KPS)scores of the two groups were higher than those before treatment,and the KPS score of the research group was higher than that of the control group,with statistical significances(P<0.05).The progression-free-survival(PFS)of the research group was higher than that of the control group,and the difference was statistically significant(P<0.05).On the 7th day after treatment,the blood sodium concentration of the two groups were higher than those before treatment,the levels of proGRP,carcinoembryonic antigen(CEA),neuron specific enolase(NSE)and carbohydrate antigen 125(CA125)were lower than those before treatment,and the blood sodium concentration of the research group was higher than that of the control group,the levels of proGRP,CEA,NSE and CA125 were lower than those of control group,and the differences were statistically significant(P<0.05).The total incidence of adverse reactions in the research group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion Xihuang Pills combined with immunotherapy and EC chemotherapy is effective in the treatment of extensive small cell lung cancer,which can delay tumor progression,reduce the expression level of tumor markers,improve the quality of life,and have high safety and practicability.