安罗替尼联合化疗治疗驱动基因阴性晚期非小细胞肺癌的疗效及对血清VEGF、bFGF、MMP-9水平的影响

Effect of combined chemotherapy with allotinib on the serum VEGF,bFGF and MMP-9 levels in the patients with advanced nonsmall cell lung cancer with driver gene negative

目的安罗替尼联合化疗治疗驱动基因阴性晚期非小细胞肺癌(NSCLC)的疗效及安全性。方法前瞻性选取2018年7月至2020年6月就诊于安徽医科大学附属宿州医院的晚期NSCLC患者60例为研究对象,随机数字表法分为观察组(n=30)和对照组(n=30)。观察组予以安罗替尼联合化疗治疗,对照组予以单纯化疗治疗。比较两组客观缓解率(ORR)、疾病控制率(DCR)、无进展生存期(PFS)、总生存期(OS)及血清血管内皮生长因子(VEGF)、碱性成纤维细胞生长因子(b FGF)、基质金属蛋白酶-9(MMP-9)、肿瘤标志物[癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)]水平变化,并观察两组不良反应。结果观察组ORR、DCR分别为20.00%、63.33%,均高于对照组的13.33%、50.00%,但组间对比差异无统计学意义(P> 0.05)。观察组中位PFS、OS分别为5.3个月和10.5个月,均优于对照组的4.1个月和8.8个月,差异有统计学意义(P <0.05)。治疗后,观察组血清VEGF、b FGF、MMP-9及CEA、CYFRA21-1水平为(163.47±19.74) pg/mL、(14.12±3.61) ng/L、(315.68±32.74) ng/mL、(35.17±8.65) ng/mL、(3.15±1.02) U/mL,均低于对照组[(196.74±21.41) pg/mL、(18.23±3.25) ng/L、(367.71±34.14) ng/mL、(42.35±9.43)ng/mL、(4.29±1.88) U/mL],差异均有统计学意义(P <0.05)。两组不良反应发生情况比较差异无统计学意义(P>0.05),以1~2级为主,经对症处理后均可缓解,患者可耐受。结论安罗替尼联合化疗治疗驱动基因阴性晚期NSCLC可提高疗效,延长患者PFS、OS,且安全性较好。

Objective To evaluate the efficacy and safety of arotinib combined with chemotherapy in the treatment of driver gene negative advanced non-small cell lung cancer( NSCLC). Methods Sixty patients with advanced NSCLC in Suzhou Hospital Affiliated to Anhui Medical University from July 2018 to June 2020 were prospectively randomly divided into observation group( n = 30) and control group( n = 30). The observation group was treated with arotinib combined with chemotherapy,and the control group was treated with chemotherapy alon. The objective response rate( ORR),disease control rate( DCR),progression free survival( PFS),overall survival( OS),serum vascular endothelial growth factor( VEGF),basic fibroblast growth factor( bFGF),matrix metalloproteinase-9( MMP-9),tumor markers [carcinoembryonic antigen( CEA),cytokeratin-19-fragment( CYFRA21-1) ]were compared between the two groups,and adverse reactions were observed. Results ORR and DCR of the observation group were 20. 00% and 63. 33% respectively,which were higher than 13. 33% and 50. 00% of the control group,but there was no significant difference between the two groups( P > 0. 05). The median PFS and OS of the observation group were 5. 3 months and 10. 5 months respectively,which were better than 4. 1 months and 8. 8 months of the control group,and the difference was statistically significant( P < 0. 05). After treatment,the serum levels of VEGF,b FGF,MMP-9,CEA and CYFRA21-1 in the observation group were( 163. 47 ± 19. 74) pg/mL,( 14. 12 ± 3. 61) ng/L,( 315. 68 ± 32. 74) ng/mL,( 35. 17 ± 8. 65) ng/mL,( 3. 15 ± 1. 02) U/mL,which were lower than those in the control group[( 196. 74 ± 21. 41) pg/mL,( 18. 23 ± 3. 25) ng/L,( 367. 71 ± 34. 14) ng/mL,( 42. 35 ± 9. 43) ng/mL,( 4. 29 ± 1. 88) U/mL],the differences were statistically significant( P < 0. 05). There was no significant difference in the incidence of adverse reactions between the two groups( P > 0. 05),mainly grade 1-2,which could be alleviated after symptomatic treatment,and patients could tolerate it. Conclusion Anlotinib combined with chemotherapy in the treatment of driver gene negative advanced NSCLC can improve the curative effect,prolong PFS and OS,and has good safety.