不同药物治疗晚期非小细胞肺癌的近期疗效及对血清肿瘤标志物的影响

The effect of different medications on the short-term efficacy and levels of serum tumor markers in patients with advanced non-small cell lung cancer

目的比较阿帕替尼与多西他赛治疗晚期非小细胞肺癌(NSCLC)的近期疗效及对血清肿瘤标志物癌胚抗原(CEA)、细胞角蛋白19片段抗原21-1(CYFRA21-1)水平的影响。方法依据不同的治疗方法将68例晚期NSCLC患者分为阿帕替尼组(n=31)和多西他赛组(n=37)。阿帕替尼组患者口服甲磺酸阿帕替尼,多西他赛组患者静脉滴注多西他赛21天为1个周期,治疗4个周期后比较两组患者的临床疗效、血清肿瘤标志物水平及不良反应发生率。结果治疗4个周期后,阿帕替尼组患者的客观反应率(ORR)为29.0%,肿瘤控制率(DCR)为67.7%,均高于多西他赛组患者的16.2%和45.9%,差异均无统计学意义(P﹥0.05)。治疗前,两组患者血清CEA、CYFRA21-1水平比较,差异无统计学意义(P﹥0.05)。治疗4个周期后,两组患者血清CEA、CYFRA21-1水平均低于本组治疗前,且阿帕替尼组患者血清CEA、CYFRA21-1水平均低于多西他赛组患者,差异均有统计学意义(P﹤0.05)。两组患者血象改变、骨髓抑制发生率比较,差异有统计学意义(P﹤0.05);多西他赛组患者的4~5级不良反应发生率27.0%,高于阿帕替尼组患者的19.4%,但差异无统计学意义(P﹥0.05)。结论阿帕替尼治疗晚期NSCLC的近期疗效优于多西他赛,可抑制肺癌相关肿瘤标志物的水平,安全性好,可作为临床治疗的选择。

Objective To investigate the short-term clinical efficacy of apatinib and docetaxel in the treatment of advanced non-small cell lung cancer(NSCLC)and the effect on serum tumor markers of carcinoembryonic antigen(CEA)and cytokeratin 19 fragment antigen 21-1(CYFRA21-1).Method A total of 68 patients with advanced NSCLC were enrolled for the retrospective analysis,patients were treated with oral apatinib mesylate(n=31)or intraveous docetaxel(n=37),with 21 days as a cycle;after 4 cycles of treatment,the short-term clinical efficacy and serum tumor marker levels,as well as the incidence of adverse reactions were evaluated and compared between the two groups.Result After 4 cycles of treatment,the objective response rate(ORR)and disease control rate(DCR)in apatinib group were 29.0%and 67.7%,which were merely numerically higher than those of the docetaxel group at 16.2%and 45.9%,respectively,indicating a difference below the significance level(P>0.05).There were no significant differences in the levels of serum tumor marker(CEA,CYFRA21-1)between the two groups before chemotherapy(P>0.05).After 4 cycles of treatment,the levels of CEA and CYFRA21-1 in the two groups were consistently reduced,and were significantly lower in apatinib group compared to docetaxel group,showing statistically significant difference(P<0.05).The incidence rates of adverse reactions including hematological change and myelosuppression in both groups were of statistically significant difference(P<0.05);the incidence rate of grade 4-5 adverse reactions in docetaxel group was 27.0%,higher than the 19.4%recorded in apatinib group,though the difference was not statistically significant(P>0.05).Conclusion Apatinib demonstrates superior short-term efficacy to docetaxel in the treatment of advanced NSCLC,oral administration of apatinib may significantly lower the level of tumor markers related to lung cancer,with fairly good safety,thus may be a recommended option for clinical treatment.