Ⅲ期非小细胞肺癌两种同步化疗方案临床研究

Clinical Study of Two Concurrent Chemotherapy Regimens for Stage Ⅲ Non-small Cell Lung Cancer

目的:探讨Ⅲ期非小细胞肺癌(NSCLC)患者予以两种同步化疗方案的临床效果,旨在进一步改善患者预后。方法:选取2019年8月—2020年8月赣州市肿瘤医院收治的88例Ⅲ期NSCLC患者,按随机数字表法分为两组,各44例。两组均行调强放疗,对照组同步EP方案(注射用依托泊苷+顺铂注射液)化疗,观察组同步TP方案[注射用紫杉醇(白蛋白结合型)+注射用奈达铂]化疗,随访2年。比较两组临床疗效、肿瘤标志物水平、生存质量、无进展生存率、总生存率及不良反应发生情况。结果:观察组疾病控制率、总有效率均高于对照组,治疗后糖类抗原125(CA125)、癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)水平均低于对照组,生存质量各领域评分均高于对照组,差异均有统计学意义(P<0.05);观察组随访1年无进展生存率、总生存率均高于对照组,随访2年总生存率高于对照组,差异均有统计学意义(P<0.05);观察组骨髓抑制发生率较对照组低,差异有统计学意义(P<0.05)。结论:注射用紫杉醇(白蛋白结合型)联合奈达铂组成的TP方案同步化疗在Ⅲ期NSCLC中效果更佳,能够提高疾病控制率及近期疗效,加快肿瘤标志物水平下降,改善生存质量,且远期生存率高,骨髓抑制风险低。

Objective:To compare the clinical effects of two concurrent chemotherapy regimens for patients with stageⅢnon-small cell lung cancer(NSCLC),in order to further improve the prognosis of patients.Method:A total of 88 patients with stageⅢNSCLC admitted to Ganzhou Cancer Hospital from August 2019 to August 2020 were selected and divided into two groups according to random number table,44 patients in each group.Both groups were treated with intensity modulated radiotherapy.The control group was treated with simultaneous EP chemotherapy(Etoposide Injection+Cisplatin Injection),and the observation group was treated with simultaneous TP chemotherapy[Paclitaxel for Injection(Albumin Bound)+Nedaplatin for Injection].The patients were followed up for 2 years.The clinical efficacy,tumor marker level,quality of life,progression free survival rate,total survival rate and adverse reactions of the two groups were compared.Result:The disease control rate and total effective rate of the observation group were higher than those of the control group,the levels of carbohydrate antigen 125(CA125),carcinoembryonic antigen(CEA)and cytokeratin 19 fragment(CYFRA21-1)after treatment were lower than those of the control group,and the scores of quality of life in each field were higher than those of the control group,the differences were statistically significant(P<0.05).The 1-year progression-free survival rate and overall survival rate of the observation group were higher than those of the control group,and the 2-year overall survival rate of the observation group was higher than that of the control group,the differences were statistically significant(P<0.05).The incidence of bone marrow suppression in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion:TP regimen composed of Paclitaxel for Injection(Albumin Bound)and Nedaplatin has better effect in stageⅢNSCLC.It can improve the disease control rate and short-term efficacy,accelerate the decline of tumor marker level,improve the quality of life,and has high long-term survival rate and low risk of bone marrow suppression.