厄洛替尼治疗老年晚期非小细胞肺癌患者的皮疹分级和近期疗效的相关性

Short-term efficacy of erlotinib in elderly patients with advanced NSCLC and its correlation with rash

目的探讨厄洛替尼治疗老年晚期非小细胞肺癌(NSCLC)患者的皮疹分级和近期疗效的相关性。方法选取2013年1月至2017年1月间商洛市洛南县医院收治的79例老年晚期NSCLC患者,均采用厄洛替尼治疗。观察治疗1个月后患者的皮疹发生情况,比较不同皮疹分级患者治疗1个月的近期疗效、治疗前后的肿瘤坏死因子(TNF)、白介素(IL)-2及白介素(IL)-6水平。结果 79例老年晚期NSCLC患者皮疹分级为:0度7例(8.9%),1度31例(39.2%),2度24例(30.4%),3度17例(21.5%)。0度患者总有效率为0.0%,1度为9.7%,2度为16.7%,3度为88.2%,四组比较,差异有统计学意义(P<0.05)。Pearson相关性分析显示,随着皮疹分级增加,近期总有效率显著增加,皮疹分级与临床疗效呈正相关,差异有统计学意义(P<0.05)。治疗前,不同皮疹分级患者的TNF、IL-2和IL-6比较,差异无统计学意义(P>0.05)。治疗后,0度患者的TNF、IL-2和IL-6与治疗前比较,差异无统计学意义(P>0.05),而1度、2度和3度患者的TNF、IL-2和IL-6水平均较治疗前升高,且随着皮疹分级增加,患者的TNF、IL-2和IL-6水平均增加。结论厄洛替尼治疗老年晚期NSCLC患者,皮疹分级越高,近期疗效越好,可能与炎性反应有关。

Objective To investigate short-term efficacy of erlotinib in elderly patients with advanced non small cell lung cancer（ NSCLC） and its correlation with rash. Methods A total of 79 elderly patients with NSCLC treated at Shangluo Luonan County Hospital from January 2013 to January 2017 were selected. All the patients were given erlotinib. The incidence of rash was observed at 1 month after the treatment. The 1-month short-term efficacy,tumor necrosis factor（ TNF）,interleukin（ IL）-2 and IL-6 levels were compared in patients with different grading rash before and after treatment. Results For grade 0 rash,there were 7 patients（ 8. 9%）. For the grade 1 rash,there were 31 patients（ 39. 2%）. For grade 2 rash,there were 24 patients（ 30. 4%）. For grade 3,there were 17 patients（ 21. 5%）. The overall response rate（ ORR） was 0 for grade 0,9. 7% forgrade 1,16. 7% for grade 2 and 88. 2% for grade 3（ all P〈0. 05）.Person relation analysis showed,the short-term ORR increased with the increase of rash grade and the rash grade was positively related with the clinical efficacy. There was no significant difference in TNF,IL-2,IL-6 levels in patients with different grading befeore the treatment（ P〈0. 05）. After treatment,no significant difference was noted in TNF、IL-2 and IL-6 level in patients with grade 0 rash（ P〈0. 05）. For patients with grade 1,grade 2 and grade 3 rash,the TNF、IL-2 and IL-6 level increased with the increase of rash grade. Conclusion When erlotinib was used for advanced NSCLC in elderly patients,the rash grade was higher,the short-term efficacy was better,which may be associated with the inflammatory reaction.