克唑替尼或吉非替尼联合GP方案治疗晚期非小细胞肺癌患者对比分析

Comparative analysis of crizotinib or gefitinib combined with GP regimen in patients with advanced non-small cell lung cancer

目的对比分析克唑替尼或吉非替尼联合GP方案(吉西他滨+顺铂)治疗晚期非小细胞肺癌患者的临床效果及其对患者免疫功能和生活质量的影响。方法选取2018年1月至2021年2月我院收治的晚期非小细胞肺癌患者150例为研究对象,采用随机数字法分为观察组和对照组各75例。观察组患者在采用GP方案治疗的基础上联合吉非替尼治疗,对照组患者在采用GP方案治疗基础上联合克唑替尼治疗。治疗30 d后,比较两组患者的临床疗效;比较两组患者治疗前后的T淋巴细胞亚群变化情况;比较两组患者治疗前后的简明健康测量量表(SF-36)、卡氏行为能力状况量表(KPS)评分以及治疗过程中的不良反应发生情况。结果治疗30 d,两组患者的治疗总有效率、控制率比较,差异均无统计学意义(P>0.05)。治疗30 d后,两组患者的CD3^(+)、CD4^(+)T淋巴细胞水平及CD4^(+)/CD8^(+)比值均显著升高,CD8^(+)T淋巴细胞水平均显著下降,差异有统计学意义(P<0.05);但治疗前后,两组患者的CD3^(+)、CD4^(+)、CD8^(+)T淋巴细胞水平及CD4^(+)/CD8^(+)比值比较,差异均无统计学意义(P>0.05)。治疗30 d后,两组患者的SF-36、KPS评分均显著提高(P<0.05);但治疗前后,两组患者的SF-36、KPS评分比较,差异均无统计学意义(P>0.05)。治疗期间,两组患者的不良反应发生率比较,差异无统计学意义(P>0.05)。结论吉非替尼或克唑替尼联合GP方案治疗晚期非小细胞肺癌患者均安全有效,可有效控制疾病进展,调控患者免疫功能,提高患者的生活质量,临床上可根据患者的具体情况选择合适的靶向治疗药物。

Objective To compare and analyze the clinical effects of crizotinib or gefitinib combined with GP regimen(gemcitabine+cisplatin)in the treatment of patients with advanced non-small cell lung cancer and its effect on patients′immune function and life quality.Methods A total of 150 non-small cell lung cancer patients admitted to our hospital from January 2018 to February 2021 were selected as the research objects,and they were divided into observation group and control group according to the random number method,with 75 cases in each group.Patients in the observation group were treated with gefitinib based on GP regimen,while patients in the control group were treated with the GP regimen in combination with crizotinib.After 30 days of treatment,the clinical efficacy of the two groups was compared.The changes of T lymphocyte subsets were compared between the two groups before and after treatment.The scores of the mos 36-item short form health survey(SF-36)and karnofsky performance status(KPS)before and after treatment were compared between the two groups.The occurrence of adverse reactions between the two groups during treatment was compared.Results With 30 days of treatment,there were no statistically significant differences in total effective rate of treatment and control rate between the two groups(P>0.05).After 30 days of treatment,the levels of CD3^(+)and CD4^(+)T lymphocytes and the ratio of CD4^(+)/CD8^(+)increased significantly,while the levels of CD8^(+)T lymphocytes decreased significantly in both groups,with statistically significant differences(P<0.05).However,there were no significant differences in the levels of CD3^(+),CD4^(+)and CD8^(+)T lymphocytes and the ratio of CD4^(+)/CD8^(+)between the two groups before and after treatment(P>0.05).After 30 days of treatment,the SF-36 and KPS scores of the two groups increased significantly(P<0.05);however,there were no statistically significant differences in SF-36 and KPS scores between two groups before and after treatment(P>0.05).During treatment,there was no statistically significant difference in the occurrence of adverse reactions between two groups(P>0.05).Conclusion Gefitinib or crizotinib combined with GP regimen are both safe and effective in the treatment of patients with advanced non-small cell lung cancer,which can effectively control disease progression,regulate the immune function of patients,and improve the life quality of patients.Clinically,appropriate targeted therapy drugs should be selected for clinical therapy according to the specific situation of patients.