深部热疗辅助安罗替尼治疗晚期肺腺癌的临床疗效及安全性

Clinical efficacy and safety of adjuvant anlotinib with deep hyperthermia in the treatment of advanced lung adenocarcinoma

目的探讨深部热疗辅助安罗替尼治疗晚期肺腺癌患者的临床疗效和安全性。方法筛选2020年6月至2021年12月扬州大学附属靖江市人民医院肿瘤内科收治的46例晚期肺腺癌患者,根据随机数字表法分为对照组(安罗替尼组)和治疗组(安罗替尼联合深部热疗组),每组患者各23例。治疗12周后进行影像学和相关血液学评估。主要观察晚期肺腺癌患者的临床疗效、症状改善、不良反应发生率、血清肿瘤标志物和生活质量等指标。结果治疗组患者客观缓解率(objectiveresponserate,ORR)(65.21%vs.34.78%)和疾病控制率(diseasecontrol rate,DCR)(91.30%vs.60.87%)均优于对照组,差异有统计学意义(χ^(2)=4.261,5.855;P=0.039,0.016)。治疗组患者咳嗽、气急、胸痛、疲乏、咳血、食欲下降好转率均优于对照组,差异有统计学意义(P<0.05)。治疗期间,治疗组患者胃肠道反应发生率低于对照组,差异有统计学意义(P<0.05)。两组患者治疗前的癌胚抗原(carcinoembryonic antigen,CEA)、血管内皮生长因子(vascular endothelial growth factor,VEGF)水平及其阳性率均高于治疗后;治疗后对照组患者的CEA、VEGF水平及其阳性率均高于治疗组,差异均具有统计学意义(P<0.05)。治疗后治疗组患者的CD3、CD4水平均高于治疗前(P<0.05),治疗组患者的CD3、CD4水平均高于对照组;两组患者治疗前的CD3、CD4水平均低于治疗后,差异均具有统计学意义(P<0.05)。治疗后治疗组患者生活质量评分优于对照组(65.22%vs.34.78%),差异有统计学意义(χ^(2)=4.261,P=0.039)。结论深部热疗辅助安罗替尼治疗晚期肺腺癌患者可明显提高ORR和DCR,缓解患者咳嗽、气急、胸痛、疲乏、咳血、食欲下降等不适表现,有效减轻药物不良反应,提升患者免疫功能,改善生活质量。

Objective:To investigate the clinical efficacy and safety of adjuvant anlotinib with deep hyperthermia in the treatment of advanced lung adenocarcinoma.Methods:A total of 46 patients with advanced lung adenocarcinoma treated in affiliated Jingjiang People's Hospital of Yangzhou University from June 2020 to December 2021.Twnety-three in the treatment group(deep hyperthermia and targeted therapy with anlotinib)and 23 in the control group(anlotinib alone)were selected.The clinical efficacy,improvement of symptoms,side effects,tumor markers and quality of life were mainly observed in patients with advanced lung adenocarcinoma.Results:Patients in the treatment group had better objective response rate(ORR)(65.21%vs.34.78%)and disease control rate(DCR)(91.30%vs.60.87%)than those in the control group(χ^(2)=4.261,P=0.039)(χ^(2)=5.855,P=0.016).The rates of improvement in cough,shortness of breath,chest pain,fatigue,hemoptysis,and anorexia in the treatment group were better than those in the control group(P<0.05).During the treatment period,the incidence of gastrointestinal effects in the treatment group was lower than that in the control group(P<0.05).The levels of carcinoembryonic antigen(CEA),vascular endothelial growth factor(VEGF)and their positive rates in two groups before treatment were higher than those after treatment(P<0.05);After treatment,the levels of CEA,VEGF and their positive in the control group were higher than those in the treatment group(P<0.05).After treatment,the levels of CD3 and CD4 in the treatment group were higher than those before treatment(P<0.05);The levels of CD3 and CD4 in the treatment group were higher than those in the control group(P<0.05).The levels of CD3 and CD4 before treatment in both groups were lower than those after treatment(P<0.05).After treatment,patients in the treatment group had a better quality of life than those in the control group(65.22%vs.4.78%)(χ^(2)=4.261,P=0.039).Conclusion:Adjuvant anlotinib with deep hyperthermia in the treatment of patients with advanced lung adenocarcinoma significantly improves objective response rate and disease control rate,relieves symptoms of cough,shortness of breath,chest pain,fatigue,hemoptysis,and anorexia,effectively reduces adverse reactions related to drugs,and also enhances the patients’immunity and quality of life.