奥西替尼靶向治疗NSCLC的近远期疗效观察

Short-term and Long-term Curative Effect of Osimertinibtargeted Therapy on NSCLC

目的探讨奥西替尼靶向治疗NSCLC的近远期疗效。方法回顾性分析80例晚期NSCLC患者临床资料,依照治疗方案将给予吉西他滨联合卡铂的化疗的患者39例纳入B组,给予奥西替尼靶向治疗的患者41例纳入A组,比较2组患者治疗前后实体瘤疗效、血清肿瘤标志物[癌胚抗原(CEA)、细胞角蛋白19片断21-1(CYFRA21-1)、神经特异性烯醇酶(NSE)、癌胚抗原125(CA125)]水平、T淋巴细胞水平、不良反应发生率以及随访2年生存结果。结果A组临床治疗有效率(80.49%)高于B组(58.97%)(P<0.05)。A组治疗后CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平高于B组,CD8^(+)水平低于B组(P<0.05)。A组治疗后血清CEA、CYFRA21-1、NSE、CA125含量低于B组(P<0.05)。A组视觉障碍、腹泻、恶心呕吐、便秘、秃头症、药物性肝损伤不良反应发生率(29.27%)低于B组(51.28%)(P<0.05)。随访截止至2020年1月31日,A组与B组1年生存率分别为:78.05%、61.54%,2年生存率分别为:58.54%、33.33%,2组1年生存率比较(P>0.05);A组2年生存率高于B组(P<0.05)。结论奥西替尼靶向治疗非小细胞肺癌近远期效果确切,可抑制血清肿瘤标志物表达,提高患者免疫力,延长生存期,且不良反应可耐受,安全性较高。

Objective To explore the short-term and long-term curative effect of Osimertinib targeted therapy on non-small cell lung cancer(NSCLC).Methods The clinical data of 80 patients with advanced NSCLC were retrospectively analyzed.According to different treatment regimens,39 patients who were underwent gemcitabine and carboplatin chemotherapy were included in group B,while 41 patients who underwent Osimertinib targeted therapy were included in group A.The curative effect on solid tumors,levels of serum tumor markers[carcinoembryonic antigen(CEA),cytokeratin 19 fragment 21-1(CYFRA21-1),neuron specific enolase(NSE),carcinoembryonic antigen 125(CA125)]and T lymphocytes,incidence of toxic and side effects before and after treatment,and 2-year survival results were compared between the 2 groups.Results The response rate of clinical treatment in group A was higher than that in group B(80.49%vs 58.97%)(P<0.05).After treatment,levels of CD3^(+)、CD4^(+)and CD4^(+)/CD8^(+) in group A were higher than those in group B,while level of CD8^(+)was lower than that in group B(P<0.05).After treatment,contents of serum CEA,CYFRA21-1,NSE and CA125 in group A were lower than those in group B(P<0.05).The incidence of toxic and side effects(visual impairment,diarrhea,nausea and vomiting,constipation,alopecia,drug-induced liver injury)in group A was lower than that in group B(29.27%vs 51.28%)(P<0.05).The follow-up ended on January 31,2020.The 1-year survival rates in groups A and B were 78.05% and 61.54%,respectively.The 2-year survival rates in both groups were 58.54% and 33.33%,respectively.There was no significant difference in 1-year survival rate between the 2 groups(P>0.05).The 2-year survival rate in group A was higher than that in group B(P<0.05).Conclusion Short-term and long-term curative effect of Osimertinib targeted therapy are significant on NSCLC,which can inhibit the expression of serum tumor markers,improve patients immunity,prolong survival,with tolerable toxic and side effects and high safety.