DP、吉非替尼联合恩度治疗非小细胞肺癌的疗效分析

Analysis of the Curative Effects of DP,Gefitinib Combined with Endostar in the Treatment of Non-small Cell Lung Cancer

目的探讨DP方案(多西紫杉醇+顺铂)方案、吉非替尼联合恩度治疗非小细胞肺癌(NSCLC)的临床疗效。方法选取2014年8月至2015年8月在我院治疗的NSCLC患者76例,将患者随机分为观察组(n=32)和对照组(n=44),观察组给予吉非替尼联合恩度治疗,对照组给予DP方案治疗。采用免疫组化法检测观察组患者治疗前切除修复交叉互补基因1(ERCC1)、β-微管蛋白表达,并随访两组患者无病生存期。结果观察组无病生存期为21(16.66~25.34)个月,明显长于对照组的15(12.98~17.02)个月,差异有统计学意义(P<0.05);观察组患者Ⅰ~Ⅱ度和Ⅲ~Ⅳ度皮疹发生率为53.13%和15.63%,均明显高于对照组(P<0.05);观察组患者Ⅰ~Ⅱ度和Ⅲ~Ⅳ度中性粒细胞减少发生率为3.13%和0.00%,均明显低于对照组(P<0.05);观察组β-微管蛋白低表达和高表达患者无病生存期分别为19(15.97~22.03)个月和25(21.60~28.40)个月,差异无统计学意义(P>0.05);观察组ERCC1低表达无病生存期为14(12.89~15.11)个月,明显低于ERCC1高表达患者的25(20.92~29.08)个月,差异有统计学意义(P<0.05)。结论吉非替尼联合恩度辅助治疗NSCLC的疗效好,ERCC1表达对吉非替尼联合恩度术后辅助治疗NSCLC有指导意义。

Objective To investigate the curative effects of DP regimen （docetaxel ＋ cisplatin）, Gefitinib combined with Endostar in the treatment of non-small cell lung cancer （NSCLC）. Methods Between August 2014 and August 2015, 76 cases of NSCLC patients were selected in this study from our hospital. The patients were randomly divided into observation group （n=32） and control group （n=44）. The observation group was given Gefitinib combined with Endostar treatment, while the control group was given DP treatment. Immunohis- tochemistry was used to detect the expression of excision repair cross complementing 1 （ERCC1） and/3-tubulin in the observation group before treatment. Patients of two groups were followed up for disease-free survival. Results The disease-free survival time of the observa- tion group was 21 （16.66 -25.34） months, which was significantly longer than that of the control group 15 （12.98-17.02） months and the difference was statistically significant （P 〈 0.05）. The incidences of adverse reactions such as skin rash of I - II and III- IV degree were respectively 53.13% and 15.63% in the observation group, both significantly higher than in the control group （P 〈 0.05）. The incidences of neutrophil reduction of I -II and III-IV degree were respectively 3.13% and 0.00% in the observation group, both significantly lower than in the control group （P 〈 0.05）. Patients with low expression or high expression ofβ-tubulin had disease-free survival of 19 （15.97 ± 22.03） months or 25 （21.60 ± 28.40） months in the observation group, and there was no statistical difference （P 〉 0.05）. In the observation group, patients with low expression of ERCC1 had disease-free survival of 14 （12.89- 15.11） months, whereas those with high expression of ERCC 1 had disease-free survival of 25 （20.92-29.08） months, and the difference was statistically significant between the two groups （P 〈 0.05）. Conclusion Gefitinib combined with Endostar adjuvant therapy had good effect in the treatment of NSCLC patients. ERCC1 expres- sion has guiding significance for Gefitinib combined with Endostar in the treatment of NSCLC.