放疗联合EGFR-TKI靶向治疗W期非小细胞肺癌的疗效及对患者内环境的影响

The curative effect of radiotherapy combined with EGFR-TKI targeted therapy for stage IV non-small cell lung cancer and its influence on internal environment in patients

目的探究放疗联合表皮生长因子受体突变-酪氨酸激酶抑制剂(EGFR-TKI )靶向治疗IV期非小细胞肺癌(NSCLC )的疗效及对患者内环境的影响’方法回顾性选取2014年3月至2017年12月本院肿瘤科收治的53例IV期EGFR突变的NSCLC患者作为研究对象,根据治疗方案分为2组,对照组(n=26)为全身化疗联合放疗,观察组(n=27)为放疗同期联合EGFR-TKI靶向治疗。观察2组患者临床疗效、免疫功能及毒副作用。结果在临床疗效方面.观察组客观有效率(0RR )为74.07%,显著高于对照组的38.46%(P < 0.05 )。在免疫功能上,观察组患者治疗后CD"较治疗前显著下降(P < 0.05 ),CD47CD8+较治疗前显著升高(P < 0.05 ),对照组患者治疗后CD8\CD47CD8+较治疗前无明显变化(P > 0.05 )组间比较,治疗后观察组患者CD"显著低于对照组(P < 0.05 ), CD"/CD"显著高于对照组(P < 0.05 )。在毒副作用上,2组患者均有发生,但未见II级以上反应,且2组患者毒副作用发生率比较差异无统计学意义(P > 0.05 )0结论对IV期NSCLC患者行放疗联合EGFR-TKI靶向治疗,显著提高临床客观有效率,改善患者内环境,提高机体免疫能力;但临床对IV期NSCLC患者制定治疗方案时,需结合多方面因素考虑。

Objective To investigate the curative effect of radiotherapy combined with epidermal growth factor receptor mutation-tyrosine kinase inhibitor (EGFR-TKI) targeted therapy for stage IV non-small cell lung cancer (NSCLC) and its influence on internal environment in patients. Methods 53 stage IV NSCLC patients with EGFR mutation admitted to oncology department of our hospital from March 2014 to December 2017 were selected retrospectively. According to the treatment plan, they were divided into two groups. The control group (〃=26) was treated with systemic chemotherapy combined with radiotherapy, and the observation group (n=27) was treated with radiotherapy combined with EGFR-TKI targeted therapy. The clinical efficacy, immune function, and toxic and side effects of the two groups were observed. Results In terms of clinical efficacy, the objective response rate (ORR) of the observation group was 74.07%, which was significantly higher than 38.46% of the control group (P<0.05). In terms of immune function, CD8 in the observation group decreased significantly after treatment (P<0.05), and CD4+/CD8 increased significantly after treatment (P<0.05), but there were no sign币cant changes in CD8+, CD4+/CD8b in the control group after treatment (/^>0.05);CD8+ in the observation group was significantly lower than that in the control group after treatment (P<0.05), while CD4+/CD8+ was significantly higher than that in the control group (P<0.05). In terms of toxicity and side effects, which occurred in both groups, but no more than grade II reactions were found, and there was no statistically significant difference in the incidence of toxicity and side effects between the two groups (P>0.05). Conclusion Radiotherapy combined with EGFR-TKI targeted therapy for stage IV NSCLC patients can significantly improve the clinical objective efficiency, improve the patients' internal environment, and improve the immune capacity of the body. However, many factors should be taken into account in the clinical treatment of stage IV NSCLC patients.