吉非替尼靶向治疗非小细胞肺癌切除化疗耐药患者的疗效

Effect of gefitinib in targeted treatment of non-small cell lung cancer patients with chemotherapy resistance after resection

目的探究晚期化疗耐药的非小细胞肺癌(NSCLC)切除患者用吉非替尼靶向治疗的疗效及对血清标志物的影响。方法选取晚期NSCLC切除患者120例,随机分为对照组和观察组,各60例。观察组用吉非替尼治疗,对照组用多西他赛联合顺铂治疗,观察并记录所有患者治疗后的疗效、不良反应及血清肿瘤标志物水平变化。结果观察组治疗有效率(RR)和疾病控制率(DCR)均显著高于对照组(P<0.05)。治疗后2组患者癌胚抗原(CEA)、鳞状上皮细胞癌抗原(SCC)和细胞角化素蛋白片段19(CY-FRA21-1)与治疗前相比显著降低(P<0.05),治疗后观察组CEA、SCC和CY-FRA21-1水平显著低于对照组(P<0.05)。观察组白细胞数量减少、中性粒细胞减少、肝功能损伤和腹泻发生率显著低于对照组(P<0.05)。观察组无进展生存期及总生存时间[(13.36±1.45)、(27.45±2.76)个月]均长于对照组[(8.15±2.47)、(18.32±1.94)个月],(P<0.05)。结论晚期化疗耐药的NSCLC切除患者用吉非替尼靶向治疗的疗效确切,可减少患者的不良反应发生率。

Objective To explore the effect of targeted therapy with gefitinib and its effect on serum markers in patients undergoing resection of non-small cell lung cancer(NSCLC)who were resistant to advanced chemotherapy.Methods A total of 120 patients with advanced NSCLC undergoing resection were selected,and randomly divided into control group and observation group,each with 60 cases.The control group were treated with gefitinib,while the observation group were treated with docetaxel combined with cisplatin.The efficacy,adverse reactions and changes in serum tumor marker levels were observed and recorded in all patients after treatment.Results The treatment response rate(RR)and disease control rate(DCR)of the observation group were significantly higher than those of the control group(P<0.05).After treatment,the carcinoembryonic antigen(CEA),squamous cell carcinoma antigen(SCC)and cytokeratin protein fragment 19(CY-FRA21-1)of the 2 groups were significantly lower than those before treatment(P<0.05).The levels of CEA,SCC and CY-FRA21-1 in the observation group were significantly lower than those in the control group(P<0.05).The number of white blood cells,decreased neutrophils,liver damage and diarrhea in the observation group were significantly lower than those in the control group(P<0.05).The progression-free survival and overall survival time of the observation group[(13.36±1.45),(27.45±2.76)months]were longer than those of the control group[(8.15±2.47),(18.32±1.94)months],(P<0.05).Conclusion Gefitinib targeted therapy for patients with advanced chemotherapy-resistant NSCLC undergoing resection has a definite effect and reduces the incidence of adverse reactions in patients.