阿法替尼靶向治疗与培美曲塞联合顺铂治疗表皮生长因子受体突变晚期非小细胞肺癌的临床疗效

Clinical efficacy of afatinib targeted therapy and pemetrexed combined with cisplatin in the treatment of advanced non-small cell lung cancer with epidermal growth factor receptor mutations

目的探讨阿法替尼靶向治疗与培美曲塞联合顺铂治疗表皮生长因子受体(EGFR)突变晚期非小细胞肺癌(NSCLC)的临床疗效。方法根据治疗方式的不同将77例EGFR突变晚期NSCLC患者分为观察组(n=41)和对照组(n=36),观察组患者接受阿法替尼靶向治疗,对照组患者接受培美曲塞联合顺铂治疗。比较两组患者的临床疗效、肿瘤标志物[癌胚抗原(CEA)、血管内皮生长因子(VEGF)、细胞角质蛋白19片段抗原21-1(CYFRA21-1)]水平、不良反应发生情况及生存情况。结果两组患者的客观缓解率(ORR)比较,差异无统计学意义(P﹥0.05);观察组患者的疾病控制率(DCR)为92.68%,高于对照组患者的75.00%,差异有统计学意义(P﹤0.05)。治疗后,两组患者的CEA、VEGF、CYFRA21-1水平均低于本组治疗前,差异均有统计学意义(P﹤0.05);治疗前后两组患者的CEA、VEGF、CYFRA21-1水平比较,差异均无统计学意义(P﹥0.05)。两组患者的不良反应发生情况比较,差异无统计学意义(P﹥0.05)。观察组患者的1年无进展生存率为43.90%,高于对照组患者的22.22%,差异有统计学意义(P﹤0.05);两组患者的1年总生存率比较,差异无统计学意义(P﹥0.05)。结论阿法替尼靶向治疗与培美曲塞联合顺铂均为治疗EGFR突变晚期NSCLC的有效方法,但阿法替尼靶向治疗可提高患者的无进展生存率且患者耐受性好。

Objective To analyze the clinical efficacy of afatinib targeted therapy and pemetrexed combined with cisplatin in the treatment of advanced non-small cell lung cancer(NSCLC)with epidermal growth factor receptor(EGFR)mutations.Method According to different treatment methods,77 advanced NSCLC patients with EGFR mutations were divided into observation group(n=41)and control group(n=36).Patients in the observation group received afatinib targeted therapy,while patients in the control group received pemetrexed combined with cisplatin therapy.The clinical efficacy,tumor markers[carcinoembryonic antigen(CEA),vascular endothelial growth factor(VEGF),and cyto-keratin 19 fragment antigen 21-1(CYFRA21-1)],adverse reactions and survival of patients were compared between the two groups.Result There was no significant difference in objective response rate(ORR)between the two groups(P>0.05).The disease control rate(DCR)of the observation group was 92.68%,which was higher than 75.00% of the control group,the difference was statistically significant(P<0.05).After treatment,the levels of CEA,VEGF and CYFRA21-1 in the two groups were lower than those before treatment,the differences were statistically significant(P<0.05).There was no significant difference in the levels of CEA,VEGF and CYFRA21-1 between the two groups before and after treatment(P>0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).The 1-year progression-free survival rate of the observation group was 43.90%,which was significantly higher than 22.22% of the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the 1-year overall survival rate between the two groups(P>0.05).Conclusion Afatinib targeted therapy and pemetrexed combined with cisplatin are both effective treatments for advanced NSCLC with EGFR mutations,but afatinib targeted therapy has certain advantage in terms of progression-free survival and is well tolerated.