吉非替尼在晚期非小细胞肺癌患者中的疗效及对肺功能的影响

Therapeutic Effect of Gefitinib on Patients with Advanced Non-small Cell Lung Cancer and Its Effect on Pulmonary Function

目的探讨吉非替尼在晚期非小细胞肺癌患者中的疗效及对肺功能的影响。方法选择2014年5月-2017年11月收治的晚期非小细胞肺癌患者100例作为对象,根据治疗方法分为对照组(n=50)和观察组(n=50)。对照组采用GP化疗方案治疗,观察组采用吉非替尼治疗,两组均进行4个疗程治疗,治疗完毕后对患者效果进行评估。根据世界卫生组织(WHO)疗效评定标准[完全缓解(CR)、部分缓解(PR)、稳定(SD)及进展(PD)]对患者有效率进行评估;采用Platinum Elite DL型肺功能测定仪对两组治疗前、治疗后20 d第1秒用力呼气容积(FEV1)、用力肺活量(FVC)及二者比值(FEV1/FVC)水平进行评估;记录并统计两组治疗后气促乏力、胸痛、咳嗽、发热、咯血及吞咽困难发生率,比较两组临床疗效及对肺功能的影响。结果观察组采用吉非替尼治疗4个疗程后有效率为44.00%,高于对照组26.00%(P<0.05);观察组与对照组治疗4个疗程后FEV1、FVC、FEV1/FVC水平高于治疗前(P<0.05);观察组治疗4个疗程后FEV1、FVC、FEV1/FVC水平高于对照组(P<0.05);观察组与对照组治疗4个疗程后气促乏力、胸痛、咳嗽、发热、咯血及吞咽困难发生率比较差异无统计学意义(P>0.05)。结论将吉非替尼用于晚期非小细胞肺癌患者中有助于提高临床疗效,改善患者肺功能水平,毒副反应发生率较低,值得推广应用。

Objective To investigate the efficacy of gefitinib in patients with advanced non-small cell lung cancer and its effect on lung function.Methods A total of 100 patients with advanced non-small cell lung cancer treated between May 2014 and November 2017 were selected as subjects. According to the treatment methods,they were divided into the control group（ n = 50）and observation group（ n = 50）. The control group was treated with the GP chemotherapy regimen while the observation group was treated with gefitinib. Both groups were treated for four cycles. The efficacy of the patients was evaluated after treatment. According to the evaluation criteria of WHO,the response rate of patients from complete remission（ CR）,partial remission（ PR）,stabilization（ SD） and progression（ PD） was evaluated. Both groups were evaluated with Platinum Elite DL-type pulmonary function tester. Before treatment and 20 days after treatment,the forced expiratory volume（ FEV1）,forced vital capacity（ FVC）,and the ratio of the two（ FEV1/FVC） levels were assessed. Post-treatment fatigue,chest pain,cough and fever in the two groups were recorded and statistically evaluated. The incidence of hemoptysis and dysphagia,clinical efficacy and the effect on lung function were compared between the two groups. Results In the observation group,the efficacy rate was 44.00% after 4 courses of treatment with gefitinib,which was higher than 26.00% in the control group（ P〈0.05）. FEV1,FVC,FEV1/FVC levels were higher after 4 courses of treatment in both groups（ P〈0.05）,especially in the observation group（ P〈0.05）. There was no significant difference in the incidence of chest pain,cough,fever,hemoptysis or dysphagia between the two groups（ P〈0.05）.Conclusion The use of gefitinib in patients with advanced non-small cell lung cancer can improve the clinical efficacy and pulmonary function. The incidence of toxic and side effects is low,which is worthy of popularization and application.