紫杉醇联合顺铂对晚期NSCLC患者的疗效及血清CEA、CA125、Cyfra21-1及NSE水平的影响

The therapeutic effects of paclitaxel combined with cisplatin on advanced NSCLC and the effects on serum levels of CEA,CA125,Cyfra21 1 and NSE

目的探讨紫杉醇联合顺铂对晚期非小细胞肺癌(NSCLC)患者的疗效及血清癌坯抗原(CEA)、糖抗原125(CA125)、细胞角质素片段抗原21-1(Cyfra21-1)、神经元特异性烯醇化酶(NSE)水平的影响。方法选取2012年1月至2016年1月确诊的晚期NSCLC患者120例,根据化疗方案分为A组60例(紫杉醇联合顺铂)、B组60例(吉西他滨联合顺铂),比较2组的化疗效果。结果 A组的总缓解率为45. 00%、总有效率为95. 00%与B组的40. 00%、88. 33%比较,差异均无统计学意义(P> 0. 05);治疗前后,2组患者血清CEA、CA125、Cyfra21-1、NSE水平差异无统计学意义(P> 0. 05);治疗后,2组患者的血清CEA、CA125、Cyfra21-1、NSE水平较本组治疗前均显著降低(P <0. 05); A组患者的恶心呕吐、腹泻、白细胞减少、血小板降低、血红蛋白降低程度显著的低于B组(P <0. 05); 2组患者的皮疹、肝肾功能损害、脱发程度比较差异无统计学意义(P> 0. 05);随访1年,A组失访3例,生存23例(40. 35%),B组失访5例,生存20例(36. 36%),2组1年生存率比较差异无统计学意义(P> 0. 05)。结论紫杉醇联合顺铂与吉西他滨联合顺铂治疗NSCLC的效果相当,但是不良反应发生率较低。

Objective To investigate the therapeutic effects of paclitaxel combined with cisplatin on advanced non small cell lung cancer(NSCLC)and the effects of paclitaxel combined with cisplatin on the serum levels of cancer antigen(CEA),carbohydrate antigen 125(CA125),cytokeratin fragment antigen 21-1(Cyfra21-1),neuron specific enolase(NSE).Methods A total of 120 patients with advanced NSCLC who were diagnosed definitely and treated in our hospital from January 2012 to January 2016 were enrolled in the study.According to the different chemotherapies,these patients were divided into group A(n=60)and group B(n=60).The patients in group A were treated by paclitaxed combined with cisplatin,however,the patients in groups B were treated by gemcitabine combined with cisplatin.The therapeutic effects were observed and compared between the two groups.Results There were no significant differences in total remission rate(45.00%vs 40.00%)and total effective rate(95%vs 88.33%)between the two groups(P>0.05).Moreover there were no significant differences in serum levels of CEA,CA125,Cyfra21-1,NSE between the two groups before and after treatment(P>0.05).After treatment,the serum levels of CEA,CA125,Cyfra21-1,NSE in both groups were significantly decreased,as compared with those before treatment(P<0.05).The severities of nausea and vomiting,diarrhea,leukocytopenia,thrombocytopenia,hemoglobin decrease in group A were significantly lower than those in group B(P<0.05).There were no significantly differences in the severities of skin rash,functional lesion of liver and kidney and degree of hair loss between the two groups(P>0.05).After 1-year follow up,3 cases were lost,23 cases were survival(40.35%)in group A,and 5 cases were lost,20 cases were survival(36.36%)in group B.There was no significant differences in 1-year survival rate between the two groups(P>0.05).Conclusion The therapeutic effects of paclitaxel combined with cisplatin are the same as those by gemcitabine combined with cisplatin on NSCLC,however the incidence rate of adverse reactions of paclitaxel combined with cisplatin is lower.