吉非替尼联合GP化疗对非小细胞肺癌的疗效

Effects of gefitinib combined with GP chemotherapy on immune function,lung function,serum ProGRP and NSE in patients with non-small cell lung cancer

目的探讨吉非替尼联合吉西他滨+顺铂(GP)化疗对非小细胞肺癌(NSCLC)患者免疫功能、肺功能及血清肺癌标志物的影响。方法选取2019年1月~2020年6月滁州市第一人民医院收治的晚期NSCLC患者70例,依据随机数字表法随机分为对照组与观察组,每组35例。对照组采用吉非替尼治疗;观察组在对照组基础上,联合GP方案治疗。21d为1个疗程,两组均治疗两个疗程。评价两组临床疗效,并比较两组患者免疫功能指标(CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)、IgA、IgG、IgM)、肺功能指标(FEV1、FVC、FEV1/FVC)、肿瘤标志物(CYFRA21-1、CEA)水平变化及不良反应发生情况。结果观察组整体临床疗效明显优于对照组(P<0.05);观察组ORR、DCR高于对照组,两组比较差异均无统计学意义(均P>0.05)。治疗前,两组上述各指标比较差异均无统计学意义(均P>0.05);治疗后,观察组CD8^(+)、CYFRA21-1、CEA均明显低于对照组,CD4^(+)、CD4^(+)/CD8^(+)、IgA、IgG、IgM、FEV1、FEV1/FVC均明显高于对照组,差异均具有统计学意义(均P<0.05)。两组皮肤不良反应、腹泻、恶心呕吐、肝功能异常等不良反应发生率比较,差异无统计学意义(P>0.05)。结论吉非替尼联合GP治疗晚期NSCLC可提高临床疗效,有效降低肿瘤标志物水平,改善免疫功能及肺功能,且不良反应发生率较低。

Objective To explore the efficacy of gefitinib combined with gemcitabine+cisplatin(GP)chemotherapy in the treatment of non-small cell lung cancer.Methods Seventy patients with advanced NSCLC were selected and randomly divided into control group and observation group according to the random number table,with 35 cases in each group.The control group was treated with gefitinib.The observation group was treated with GP regimen on the basis of the control group.21d was 1 course of treatment,and both groups were treated for 2 courses.To evaluate the clinical efficacy of the two groups,and compare the immune function indexes(CD4^(+),CD8^(+),CD4^(+)/CD8^(+),IgA,IgG,IgM),lung function indexes(FEV1,FVC,FEV1/FVC),tumor markers(CYFRA21-1,CEA)changes in levels and occurrence of adverse reactions.Results The overall clinical efficacy of the observation group was significantly better than that of the control group(P<0.05).The ORR and DCR of the observation group were higher than those of the control group,but the difference between the two groups was not statistically significant(all P>0.05).Before treatment,there was no statistically significant difference in the above indicators between the two groups(all P>0.05).After treatment,the observation group CD8^(+),CYFRA21-1,CEA were significantly lower than the control group,CD4^(+),CD4^(+)/CD8^(+),IgA,IgG,IgM,FEV1,FEV1/FVC were significantly higher than the control group,and the differences were statistically significant(All P<0.05).There was no significant difference in the incidence of adverse reactions such as skin adverse reactions,diarrhea,nausea and vomiting,abnormal liver function between the two groups(P>0.05).Conclusion Gefitinib combined with GP in the treatment of advanced NSCLC can improve the overall clinical efficacy,and can effectively reduce the level of tumor markers,improve immune function and lung function,and have a lower incidence of adverse reactions.