吉非替尼联合三维适形放疗治疗老年晚期非小细胞肺癌的效果及对血清肿瘤标志物的影响

Effect of Gefitinib Combined with Three-dimensional Conformal Radiotherapy in Elderly Patients with Advanced Non-small Cell Lung Cancer and Its Influence on Serum Tumor Markers

目的探讨吉非替尼联合三维适形放疗治疗老年晚期非小细胞肺癌(NSCLC)的近远期疗效及对血清肿瘤标志物的影响。方法选择2013年5月—2014年11月我院收治的老年晚期NSCLC患者79例,根据治疗方法不同分为观察组42例和对照组37例;观察组给予三维适形放疗联合吉非替尼,对照组给予三维适形放疗。评价2组治疗后的近期疗效和远期疗效[5年无进展生存时间(PFS)和总生存时间(OS)]。比较2组治疗前后癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)含量及毒副反应发生情况。结果观察组近期总有效率高于对照组(P<0.05),观察组PFS、OS长于对照组(P<0.05,P<0.01)。与治疗前比较,2组治疗后血清CEA、CYFRA21-1含量均显著降低,且观察组低于对照组(P<0.01)。2组毒副反应总发生率比较差异无统计学意义(P>0.05)。结论吉非替尼联合三维适形放疗治疗老年晚期NSCLC能取得较单用三维适形放疗更为优越的近远期疗效,且有利于血清肿瘤标志物的降低,治疗安全性好。

Objective To investigate the short-term and long-term efficacy of Gefitinib combined with three-dimensional conformal radiotherapy(3D-CRT)in the treatment of elderly patients with advanced non-small cell lung cancer(NSCLC)and its influence on serum tumor markers.Methods We selected 79 elderly patients with advanced NSCLC in our hospital from May 2013 to November 2014 and divided them into observation group(n=42)and control group(n=37)according to different treatment methods.The observation group was given 3D-CRT combined with Gefitinib,and the control group was given 3D-CRT.The short-term and long-term effects[5-year progression-free survival(PFS)and overall survival time(OS)]were evaluated.The contents of carcinoembryonic antigen(CEA)and cytokeratin 19 fragment(CYFRA21-1)before and after treatment as well as toxic side-effects were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group(P<0.05).PFS and OS of the observation group were longer than those of the control group(P<0.05,P<0.01).Compared with those before treatment,the levels of CEA and CYFRA21-1 in the two groups after treatment were significantly lower,and the levels were lower in the observation group than in the control group(P<0.01).There was no significant difference in the total incidence of toxic side-effects between the two groups(P>0.05).Conclusion Gefitinib combined with 3D-CRT in the treatment of elderly patients with advanced NSCLC can achieve better short-term and long-term efficacy than that of 3D-CRT alone,which is conducive to the reduction of tumor markers and has good safety.