吉非替尼联合吉西他滨和顺铂化疗方案治疗晚期非小细胞肺癌临床疗效及对血清肿瘤标志物的影响

Clinical Efficacy of Gefitinib Combined with Gemcitabine and Cisplatin Chemotherapy in Treatment of Patients with Advanced Non-small Cell Lung Cancer and Its Effects on Serum Tumor Markers

目的探讨吉非替尼联合吉西他滨和顺铂(GP)化疗方案治疗晚期非小细胞肺癌的临床疗效及对血清肿瘤标志物的影响。方法选取秦皇岛市第四医院2014年3月—2015年5月收治的晚期非小细胞肺癌106例,按治疗方式分为研究组与对照组,每组53例。对照组采用GP方案治疗,研究组在对照组基础上联合吉非替尼治疗。比较两组临床疗效、治疗前后神经烯醇化酶(NSE)、细胞角蛋白19片段(CYFRA21-1)、糖类抗原199(CA199)的水平变化情况,观察两组不良反应发生情况。结果治疗后,两组血清NSE、CYFRA21-1水平低于治疗前,且研究组低于对照组(P<0.05)。研究组客观有效率高于对照组(P<0.05)。两组主要不良反应均为骨髓抑制和胃肠道反应,研究组白细胞减少、血小板减少发生率低于对照组(P<0.05)。结论 GP方案治疗晚期非小细胞肺癌临床疗效较好,血清NSE可以作为晚期非小细胞肺癌化疗疗效的评价指标。

Objective To investigate clinical efficacy of Gefitinib combined with Gemcitabine and Cisplatin(GP)chemotherapy in treatment of advanced non-small cell lung cancer and its effects on serum tumor markers.Methods A total of 106 patients with advanced non-small cell lung cancer admitted during March 2014 and May 2015 were divided into study group(n=53)and control group(n=53).Control group was treated with GP chemotherapy,while study group was added with Gefitinib on the basis of treatment for control group.Clinical efficacy,changes of neuron-specific enolase(NSE),cytokeratin 19(CYFRA21-1)and carbohydrate antigen 199(CA199)levels before and after treatment were compared between two groups,and incidence rate of adverse reactions were observed in two groups.Results After treatment,serum NSE and CYFRA21-1 levels were significantly lower than those before treatment in two groups,and the levels in study group were significantly lower than those in control group(P<0.05).Objectively effective rate in study group was significantly higher than that in control group(P<0.05).Mainly adverse reactions were myelosuppression and gastrointestinal reactions in two groups.Incidence rates of myelosuppression such as leukopenia and thrombocytopenia in study group were significantly lower than those in control group(P<0.05).Conclusion GP chemotherapy may achieve good clinical efficacy,and serum NSE can be used as an indicator of chemotherapy efficacy in treatment of patients with advanced non-small cell lung cancer.