贝伐珠单抗联合培美曲塞加顺铂治疗晚期驱动基因阴性肺腺癌的效果及不良反应分析

Efficacy and Side Effects of Bevacizumab Combined with Pemetrexed and Cisplatin in the Treatment of Advanced Lung Adenocarcinoma with Driver Negative Gene

目的:探讨贝伐珠单抗联合培美曲塞加顺铂对晚期驱动基因阴性肺腺癌的疗效及不良反应。方法:回顾性收集并分析2015年9月-2019年9月北京大学第三医院延庆医院收治的驱动基因阴性晚期肺腺癌62例患者的临床资料,接受培美曲塞加顺铂治疗的30例作为对照组,接受贝伐珠单抗联合培美曲塞加顺铂化疗的32例作为研究组,对比两组患者治疗前后血清中CEA、CA125水平,统计分析两组临床疗效和不良反应生情况。主要研究终点为无进展生存期(PFS)和药物不良反应。采用Kaplan-Meier进行生存分析。结果:治疗后,两组患者血清中肿瘤标志物水平均降低,研究组较对照组下降幅度更大,差异有统计学意义(P<0.05)。研究组ORR 59.38%,DCR 90.63%,高于对照组的30.00%、70.00%。研究组PFS为10个月,对照组PFS为6个月,差异有统计学意义(P<0.05)。研究组不良反应发生率为36.67%(11/30),对照组不良反应发生率为28.13%(9/32),两组不良反应发生率比较差异无统计学意义(P>0.05)。结论:晚期驱动基因阴性的肺腺癌患者采用贝伐珠单抗联合培美曲塞加顺铂治疗,能够有效提高临床效果,延长生存期,不良反应可接受。

Objective:To evaluate the efficacy and side effects of Bevacizumab combined with Pemetrexed plus Cisplatin in the treatment of advanced driver negative lung adenocarcinoma.Method:From September 2015 to September 2019,the clinical data of 62 patients with advanced lung adenocarcinoma who were treated in Peking University Third Hospital Yanqing Hospital were analyzed retrospectively,30 patients treated with Pemetrexed plus Cisplatin were set as the control group,32 patients treated with Bevacizumab plus Pemetrexed and Cisplatin were set as the study group.The levels of CEA and CA125 in serum were compared before and after treatment,the clinical effect and adverse reaction of the two groups were analyzed statistically.The primary end points were progressionfree survival(PFS)and adverse drug reactions.Kaplan-Meier survival analysis were used.Result:After treatment,the levels of serum tumor markers in the two groups were significantly lower than those in the control group(P<0.05).The ORR of 59.38%,DCR of 90.63%in the study group were higher than 30.00%,70.00%in the control group.PFS in the study group was 10 months,PFS in the control group was 6 months,and the difference was statisticaly(P<0.05).The incidence of adverse reactions was 36.67%(11/30)in the study group and 28.13%(9/32)in the control group.There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Bevacizumab combined with Pemetrexed plus Cisplatin can effectively improve the clinical efficacy and prolong the survival time of patients with lung adenocarcinoma with driver negative gene.