克唑替尼联合沙利度胺治疗老年晚期非小细胞肺癌临床研究

Clinical study on crizotinib combined with thalidomide scheme in treatment of elderly patients with advanced non-small cell lung cancer

目的探究克唑替尼联合沙利度胺治疗老年晚期非小细胞肺癌(NSCLC)临床效果及安全性。方法选取我院2015年1月至2017年2月所收治疗的72例晚期非小细胞肺癌(Ⅲ-Ⅳ期)患者,随机分为克唑替尼组(n=36)和联合组(n=36),克唑替尼组仅给予克唑替尼胶囊250mg bid;联合组在克唑替尼组基础上,联合沙利度胺(起始为100 mg/d,1周后加至200 mg/d),疗程为6个周期。对比两组治疗效果、不良反应、生活质量。结果治疗3、6周期后各组比较:克唑替尼联合沙利度胺后有效率分别为41.67%、55.55%;疾病控制率66.67%、86.11%。两组患者不良反应发生率无明显差异(P>0.05);联合治疗后生活质量明显高于单药克唑替尼组(P<0.05)。结论克唑替尼联合沙利度胺治疗老年晚期非小细胞肺癌的临床疗效优于常规靶向治疗,可提高患者生活质量,不良反应可耐受。

Objective To investigate the clinical efficacy and safety of crizotinib combined with thalidomide scheme in treatment of elderly patients with advanced non-small cell lung cancer.Methods A total of 72 elderly patients with locally advanced non-small cell lung cancer from January 2015 to February 2017 were enrolled in the study.The patients were randomly divided into the crizotinib group(n=36)and the combination group(crizotinib combined with thalidomide)(n=36).The crizotinib group received oral treatment with crizotinib(250 mg)twice daily,and the combination group was given crizotinib combined with thalidomide treatment(started at 100 mg/d and added to 200 mg/d after 1 weeks).All of them were treated for 6 cycles,of which the efficacy adverse reactions and quality of life were evaluated.Results 3 and 6 cycles after treatment,the effective rate was 41.67%and 55.55%respectively,and the rate of disease control was 66.67%and 86.11%respectively.There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).The quality of life in the combined treatment group was significantly higher than that in the crizotinib group(P<0.05).Conclusion The results indicate crizotinib combined with thalidomide is superior to standard targeted therapy for advanced NSCLC,which can effectively improve the quality of life,with tolerable adverse reactions.