替吉奥联合长春瑞滨治疗进展期非小细胞肺癌的疗效以及对COX-2和MMP-9水平的影响

Clinical Observation of S-1 Combined with Vinorelbine for Advanced Non-small Cell Lung Carcinoma and Its Effect on COX-2 and MMP-9

目的比较长春瑞滨(NVB)联合替吉奥(S-1)或顺铂治疗进展期非小细胞(NSCLC)的临床疗效及不良反应。方法选择进展期NSCLC患者80例,随机分为观察组和对照组。观察组采用NVB联合S-1方案:S-1 200 mg/m2(体表面积≤1. 25 m2)或300 mg/m^2(体表面积> 1. 25 m2),d2~d6、d9~d13; NVB 25 mg/m2静脉滴注,d1、d8。对照组采用NP方案:NVB 20 mg/m2静脉滴注,d1、d8;顺铂30 mg/m^2,d1~d3。比较2组短期疗效、KPS评分,比较化疗后患者生活质量以及不良反应,分析患者治疗前后血清环氧合酶2(COX-2)和基质金属蛋白酶9(MMP-9)的变化。结果观察组有效率(ORR)和疾病控制率(DCR)分别45. 0%和77. 5%,对照组为40. 0%和65. 0%,2组间治疗效果无明显差异。化疗后观察组患者生活质量优于对照组(P <0. 05),严重不良反应发生率明显低于对照组(P <0. 05)。化疗可降低患者血清COX-2和MMP-9水平,观察组患者改善效果更明显(P <0. 05),且化疗后患者COX-2和MMP-9水平随着治疗效果下降而升高。结论 NVB联合S-1治疗进展期NSCLC与NP方案比较,疗效无明显差异,但NVB联合S-1化疗后患者生活质量更高,毒副作用小。COX-2和MMP-9水平可作为预测和反映化疗效果的指标。

Objective To compare the clinical and side effect of vinorelbine(NVB)combined with S-1 or cisplatin in the treatment of advanced none-small lung carcinoma(NSCLC).Methods 80 patients with NSCLC were randomly divided into the observation group and the control group.The observation group was treated with NVB combined with S-1 program:S-1 200 mg/m 2(body surface area less≤1.25 m 2)or 300 mg/m 2(body surface area>1.25 m 2),d 2~d 6,d 9~d 13,NVB 25 mg/m 2vein Infusion,d 1,d 8;control group using NP program:NVB 20 mg/m 2 intravenous infusion,d 1,d 8,cisplatin 30 mg/m 2,d 1~d 3.Comparison the short-term efficacy,life quality and adverse reactions after chemotherapy.Results The Overall Response Rate(ORR)and disease control rate(DCR)were 45.0%and 77.5%in the observation group,40.0%and 65.0%in the control group.The live quality was higher and adverse reaction was lower of the observation group than control group.Chemotherapy reduced the serum levels of COX-2 and MMP-9,which in the observation group was more obvious(P<0.05).Conclusion NVB combined with S-1 treatment of advanced NSCLC has the same treatment effect to NP programe,but NVB combined with S-1 patients with higher quality of life and lower side effects after chemotherapy.COX-2 and MMP-9 levels can be used as indicators to predict and reflect the efficacy of chemotherapy.