西妥昔单抗联合NP方案治疗晚期非小细胞肺癌的疗效及其对患者免疫功能的影响

Efficacy of cetuximab combined with NP regimen for patients with advanced non-small cell lung cancer and its effects on immune function

目的探讨西妥昔单抗(C225)联合NP方案(顺铂^+长春瑞滨)治疗对晚期非小细胞肺癌的疗效及其对患者免疫功能和生存期的影响。方法选取2013年1月至2015年2月在我院深圳市龙岗中心医院肿瘤科确诊为ⅢB/Ⅳ期非小细胞肺癌患者80例,采用随机数表法均分为对照组和观察组,每组40例。对照组采用NP方案治疗,观察组在对照组基础上联合C225治疗,连续治疗2个疗程。比较两组患者治疗后的临床疗效、免疫功能指标变化及不良反应,并比较两组患者的3年生存率、3年无瘤生存率。结果观察组患者的治疗总有效率和控制率分别为87.5%、95.0%,均明显高于对照组的60.0%和87.5%,差异均有统计学意义(P≤0.05);观察组患者治疗后的CD4^+T细胞百分比、CD4^+T/CD8^+T细胞比值、IgM及IgG水平分别为(38.5±3.1)%、1.2±0.2、(1.4±0.2) g/L、(23.5±3.2) g/L,均明显高于对照组的(23.5±2.8)%、0.5±0.1、(1.3±0.2) g/L、(15.0±2.8) g/L,差异均有统计学意义(P<0.05);观察组患者治疗期间的毒副反应总发生率为17.5%,高于对照组的7.5%,但差异无统计学意义(P>0.05);观察组患者的3年生存率、3年无瘤生存率分别为67.5%、52.5%,明显高于对照组的50.0%和37.5%,差异均有统计学意义(P<0.05)。结论 C225联合NP方案可以提高晚期非小细胞肺癌患者临床疗效与3年生存率,可能与C225调节机体免疫功能有关。

Objective To explore the efficacy of cetuximab (C225) combined with NP regimen (cisplatin + vinorelbine) in the treatment of patients with advanced non-small cell lung cancer and its effects on immune function and survival time. Methods Eighty patients diagnosed as stage ⅢB/IV non-small cell lung cancer in Department of Oncology, Shenzhen Longgang Central Hospital from January 2013 to February 2015 were selected and divided into control group and observation group according to the number table method, with 40 cases in each group. The control group was treated with NP regimen, and the observation group applied C225 on the basis of NP regimen. The two groups of patients were continuously treated for 2 courses. The clinical efficacy, immune function indexes changes, and adverse reactions were compared between the two groups after treatment, as well as the 3-year survival rate, and 3-year disease-free survival rate. Results After treatment, the total effective rate of treatment and control rate in observation group were 87.5%, 95.0%, significantly higher than 60.0%, 87.5% in control group (P≤0.05). The CD4+T cell percentage, CD4+T/ CD8+ T cell ratio, and levels of IgM, and IgG in observation group after treatment were (38.5±3.1)%, 1.2±0.2,(1.4±0.2) g/L,(23.5±3.2) g/L, significantly higher than (23.5±2.8)%, 0.5±0.1,(1.3±0.2) g/L,(15.0±2.8) g/L in the control group (P< 0.05). The incidence rate of toxic and side effects in observation group was higher than that in control group (17.5% vs 7.5%, P>0.05). The 3-year survival rate and 3-year disease-free survival rate in observation group were 67.5%, 52.5%, significantly higher than 50.0%, 37.5% in the control group (P<0.05). Conclusion C225 combined with NP regimen can improve the clinical efficacy and 3-year survival rate of patients with advanced non-small cell lung cancer, which may be related to the regulation of immune function by C225.