易瑞沙靶向治疗晚期非小细胞肺癌的疗效观察

Effects of iressa on advanced non-small cell lung cancer

目的探究易瑞沙靶向治疗晚期非小细胞肺癌(NSCLC)的疗效,为晚期NSCLC的治疗提供理论依据。方法回顾性分析2016年5月至2018年5月濮阳市安阳地区医院收治的90例晚期NSCLC患者的临床资料,所有患者均经1个周期以上含铂化疗方案治疗无效。入组后,患者采用易瑞沙靶向治疗,250 mg/d,口服,连续治疗6个月。随访2年,观察患者治疗效果,记录治疗后1、2年无肿瘤进展生存率以及总生存率。治疗前、后抽取患者外周静脉血,采用流式细胞仪检测外周血CD3+、CD4+、CD8+、CD4+/CD8+以及自然杀伤(NK)细胞水平。采用欧洲癌症治疗组织生活质量调查核心问卷(EORTC QLQ-C30)简体中文版及肺癌专用问卷(QLQ-LCI3)评价患者生活质量,记录治疗期间不良反应发生情况。结果治疗6个月后,完全缓解率为4.44%(4/90),部分缓解率为41.11%(37/90),稳定率为26.67%(24/90),进展率为27.78%(25/90),治疗有效率为45.55%(41/90);1年无肿瘤进展生存率以及总生存率分别为30.00%(27/90)与51.11%(46/90),2年无肿瘤进展生存率以及总生存率分别为6.67%(6/90)与23.33%(21/90)。治疗6个月后,CD3+、CD4+、NK细胞水平以及CD4+/CD8+均高于治疗前,CD8+低于治疗前,差异有统计学意义(P<0.05)。治疗后,EORTC QLQ-C30问卷中体力评分、功能评分、情感评分、认知评分、社会角色均高于治疗前,差异有统计学意义(P<0.05);QLQ-LCI3问卷中乏力、食欲减退、憋气、咳嗽、胸闷评分均低于治疗前,差异有统计学意义(P<0.05)。不良反应包括皮疹、腹泻、溃疡、食欲不振、舌炎、谷氨酰胺转移酶升高,但均较为轻微。结论晚期NSCLC患者采用易瑞沙靶向治疗能够显著提升患者细胞免疫功能,改善生活质量,同时不良反应较轻,适合用于晚期NSCLC的非化疗治疗。

Objective To investigate the therapeutic effects of iressa on advanced non-small cell lung cancer(NSCLC),and to provide a theoretical basis for the treatment of advanced NSCLC.Methods Clinical data from 90 patients with advanced NSCLC treated in Anyang District Hospital of Puyang City from May 2016 to May 2018 were retrospectively analyzed.All patients had been treated by invalid platinum-based chemotherapy for over 1 course.After entering the group,iressa targeted therapy was used,the dosage was 250 mg taken by mouth once a day for 6 months.Patients were followed up for 2 years to observe the treatment effects,and to record tumor progression-free survival rate and total survival rate 1 and 2 years after treatment.Peripheral venous blood samples were extracted from all patients before and after treatment,peripheral blood cluster differentiation(CD)3+,CD4+,CD8+,CD4+/CD8+and natural killer(NK)cell levels were detected by flow cytometry before and after treatment.Standard Chinese version of European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30(EORTC QLQ-C30)and Quality of Life Questionnaire Lung Cancer-13(QLQ-LCI3)were used to evaluate patients’life quality.The incidences of adverse reactions during treatment were recorded.Results Complete remission(CR)rate was 4.44%(4/90),partial remission(PR)rate was 41.11%(37/90),stable disease(SD)rate was 26.67%(24/90),progression rate(PD)was 27.78%(25/90),and the effective rate was 45.55%(41/90)6 months after treatment.The 1-year tumor progression-free survival rate and total survival rate were 30.00%(27/90)and 51.11%(46/90)respectively,while the 2-year tumor progression-free survival rate and total survival rate were 6.67%(6/90)and 23.33%(21/90).After 6 months of treatment,CD3+,CD4+,NK and CD4+/CD8+levels were significantly higher than those before treatment,however,CD8+level was significantly lower than that before treatment(P<0.05).After treatment,physical score,function score,emotional score,cognitive scores,social role in EORTC QLQ-C30 were higher than those before treatment(P<0.05).Scores of fatigue,lack of appetite,shortness of breath,cough,chest suppression in QLQ-LCI3 were significantly lower than those before treatment(P<0.05).The adverse reactions were mild,including rash,diarrhea,loss of appetite,glossitis,transglutaminase increase.Conclusions Adopting iressa in the treatment of advanced NSCLC can significantly improve immune function and quality of life,at the same time,with mild adverse reactions,which is suitable for non chemotherapy treatment of advanced NSCLC.