阿法替尼、培美曲塞、吉西他滨联合化疗治疗晚期NSCLC的效果及对血清肿瘤标志物、免疫功能、生活质量的影响

Effect of Combination Chemotherapy of Afatinib,Pemetrexed and Gemcitabine on Advanced Non-small Cell Lung Cancer and Its Influence on Tumor Markers,Immune Function and Quality of Life

目的探究阿法替尼、培美曲塞、吉西他滨联合化疗治疗晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)的效果及对血清肿瘤标志物、免疫功能、生活质量的影响。方法选取2017年6月-2018年6月我院接受治疗的120例晚期NSCLC患者,据治疗方法的不同分为研究组62例和对照组58例,研究组予阿法替尼、培美曲塞、吉西他滨联合化疗,对照组予培美曲塞联合阿法替尼化疗,共行4~6个周期化疗。据治疗前后胸部CT检查结果比较两组疾病控制率(DCR),比较两组治疗前后血清癌抗原125(CA125)、癌胚抗原(CEA)、神经元特异烯醇化酶(NSE)、CD3+、CD4+、CD8+、CD4+/CD8+水平及健康状况调查简表(36-itemshort-form,SF-36)评分,以及治疗期间化疗不良反应。结果治疗后,研究组DCR为79.03%高于对照组的60.34%(P<0.05)。治疗后,两组CA125、CEA及NSE降低,且研究组降低幅度大于对照组,差异均有统计学意义(P<0.05或P<0.01)。治疗后,两组CD3+、CD4+、CD4+/CD8+均较治疗前升高,CD8+较治疗前降低,且研究组治疗后CD3+、CD4+、CD4+/CD8+高于对照组治疗后,CD8+低于对照组治疗后,差异均有统计学意义(P<0.05)。治疗后,两组SF-36各维度评分均升高,且研究组SF-36各维度评分升高程度均大于对照组,差异均有统计学意义(P<0.05或P<0.01)。两组治疗期间不良反应发生率比较差异无统计学意义(P>0.05)。结论晚期NSCLC患者采用阿法替尼、培美曲塞、吉西他滨联合化疗可有效控制疾病进展,降低血清肿瘤标志物水平,改善机体免疫功能,提高生活质量,且并未增加化疗不良反应,安全性良好。

Objective To explore the effect of combination chemotherapy of Afatinib,Pemetrexed and Gemcitabine on advanced non-small cell lung cancer(NSCLC)and its influence on tumor markers,T lymphocyte immune function and quality of life.Methods A total of 120 patients with advanced NSCLC who were treated in our hospital from June 2017 to June 2018 were selected as the research subjects.According to different treatment methods,they were divided into research group(n=62)and control group(n=58).The research group was treated with combination chemotherapy of Afatinib,Pemetrexed and Gemcitabine,while the control group was treated with combination chemotherapy of Pemetrexed and Afatinib,with a total of 4-6 cycles of chemotherapy.According to the results of chest CT examination before and after treatment,the disease control rate(DCR)of the two groups was compared,and the levels of serum antigen 125(CA125),carcinoembryonic antigen(CEA),neuron specific enolase(NSE),CD3+,CD4+,CD8+,CD4+/CD8+before and after treatment,as well as the scores of 36 item short form health survey(SF-36)and adverse reactions of chemotherapy during the treatment were compared.Results After treatment,the DCR of the research group was 79.03%,which was higher than that of the control group(60.34%)(P<0.05).After treatment,CA125,CEA and NSE were decreased in the two groups,and the decrease in the research group was greater than that in the control group(P<0.05 or P<0.01).After treatment,CD3+,CD4+,and CD4+/CD8+of the two groups were higher than those before treatment,and CD8+was lower than that before treatment.After treatment,CD3+,CD4+,CD4+/CD8+of the research group were higher than those of the control group,and CD8+was lower than that of the control group(P<0.05).After treatment,the scores of SF-36 in the two groups were increased,and the scores of SF-36 in the research group were significantly higher than those in the control group(P<0.05 or P<0.01).There was no significant difference in adverse reaction rate during treatment between two groups(P>0.05).Conclusion The combination chemotherapy of Alfatinib,Pemetrexed and Gemcitabine can effectively control the progression of advanced NSCLC,reduce the level of tumor markers,improve the immune function,and improve the quality of life of patients with advanced NSCLC.In addition,it will not increase the adverse reactions of chemotherapy with good safety.