单药白蛋白结合型紫杉醇治疗晚期非小细胞肺癌的疗效及安全性分析

Efficacy and safety of nanoparticle albumin-bound paclitaxel monotherapy in the treatment of advanced non-small cell lung cancer

目的探讨单药白蛋白结合型紫杉醇(nab-PC)治疗晚期非小细胞肺癌(NSCLC)的疗效及安全性。方法选取52例NSCLC患者为研究对象,第1、8天给予单药nab-PC静脉滴注,21天为1个周期,治疗2～6个周期后,对患者化疗后的疗效和安全性进行观察和评价。结果 52例NSCLC患者的客观缓解率(ORR)和疾病控制率(DCR)分别为23.08%和73.08%,不同性别、年龄、吸烟情况、合并症情况、临床分期、病理分型、美国东部肿瘤协作组(ECOG)评分、放疗线数、紫杉醇类药物化疗史的NSCLC患者的ORR和DCR比较,差异均无统计学意义(P﹥0.05)。52例NSCLC患者的中位无进展生存时间(PFS)和中位总生存时间(OS)分别为4.1个月和11.3个月。鳞癌患者的中位PFS和中位OS均长于非鳞癌患者(P﹤0.05)。NSCLC患者化疗后出现的不良反应多为1～2级,且均可耐受。≥70岁的NSCLC患者3级及以上脱发和中性粒细胞减少的发生率均高于﹤70岁的患者(P﹤0.05),多种合并症的NSCLC患者3级及以上脱发、中性粒细胞减少、血红蛋白减少和恶心呕吐的发生率均高于单一合并症的患者(P﹤0.05)。结论单药nab-PC治疗晚期NSCLC的适用性广,疗效确切,不良反应较轻,患者均可耐受。对于≥70岁和多种合并症的NSCLC患者,应做好治疗前的预防工作。

Objective To evaluate the efficacy and safety of nanoparticle albumin-bound paclitaxel（nab-PC） monotherapy in the treatment of advanced non-small cell lung cancer（NSCLC）. Method 52 patients with NSCLC were included in the study, and were given intravenous infusion of nab-PC on day 1 and 8 in each 21-day cycle, and the efficacy and safety of the chemotherapy were observed and evaluated after 2-6 cycles. Result In the 52 patients, the objective response rate（ORR） and disease control rate（DCR） were 23.08% and 73.08%, respectively, and there were no statistically significant difference between the ORR and DCR of NSCLC patients in regard of gender, age, smoking history, comorbidities, clinical stage, pathological type, ECOG score, line of chemotherapy, history of paclitaxel chemotherapy（P〉0.05）.The median progression-free survival time（PFS） and median overall survival time（OS） were 4.1 and 11.3 months, respectively. The median PFS and median OS in squamous cell carcinoma patients were longer than those with non-squamous cell carcinoma, and the differences were statistically significant（P〈0.05）. The adverse reactions after chemotherapy were mostly grade 1 or 2, and were tolerable. The incidence of alopecia and neutropenia of grade 3 and above were higher in those aged ≥70 than those aged 〈70（P〈0.05）; the incidence of alopecia, neutropenia, hemoglobin decreased, nausea and vomiting of grade 3 and above were higher in those with multiple comorbidities than those with single comorbidity（P〈0.05）. Conclusion In the treatment of advanced NSCLC, simple nab-PC is widely applicable, with fair curative effect,and mild yet tolerable adverse reactions. For elderly patients who are over 70, and those with multiple comorbidities, prophylactic strategies should be considered before treatment.