阿来替尼联合吉西他滨治疗肺腺癌临床研究

Clinical Study of Alectinib Combined with Gemcitabine in the Treatment of Lung Adenocarcinoma

目的 探讨阿来替尼靶向治疗联合吉西他滨化学治疗(简称化疗)对肺腺癌患者近期疗效及不良反应的影响。方法 选取医院2020年1月至2021年2月收治的肺腺癌患者110例,按随机信封法分为研究组和对照组,各55例。对照组患者予吉西他滨化疗方案,研究组患者在对照组基础上联合阿来替尼靶向治疗,均治疗6个月。结果 研究组的客观缓解率为63.64%,明显高于对照组的43.64%(P<0.05)。治疗6个月后,两组患者的血清生化指标(血管内皮生长因子、神经元特异性烯醇化酶、基质金属蛋白酶-9)、肿瘤标志物(癌胚抗原、细胞角蛋白19片段抗原21-1、糖类抗原125)、免疫球蛋白E水平均较治疗前明显降低,且研究组均明显低于对照组(P<0.05);两组患者免疫球蛋白A水平、CD_(4)^(+)/CD_(8)^(+)、肺癌治疗功能评定量表(FACT-L)各项评分均较治疗前明显升高,且研究组均明显高于对照组(P<0.05)。治疗期间,研究组患者不良反应发生率为34.55%,明显低于对照组的54.55%(P<0.05)。结论 阿来替尼靶向治疗联合吉西他滨化疗可有效提高肺腺癌患者的近期疗效,降低患者的肿瘤增殖及转移风险,促进免疫系统功能恢复,提高患者的生活质量,且治疗安全性较好。

Objective To investigate the effect of alectinib-targeted therapy combined with gemcitabine chemotherapy on the short-term efficacy and adverse reactions in patients with lung adenocarcinoma.Methods A total of 110 patients with lung adenocarcinoma admitted to the hospital from January 2020 to February 2021 were selected and divided into the study group and the control group by the random envelope method,with 55 cases in each group.The patients in the control group were treated with gemcitabine chemotherapy regimen,while the patients in the study group received alectinib-targeted therapy on the basis of the control group.Both groups were treated for six months.Results The objective response rate in the study group was 63.64%,which was significantly higher than 43.64%in the control group(P<0.05).After six months of treatment,the serum biochemical indicators[vascular endothelial growth factor(VEGF),neuron-specific enolase(NSE),serum matrix metalloproteinase-9(MMP-9)],tumor markers[serum carcinoembryonic antigen(CEA),cytokeratin 19 fragment antigen 21-1(CYFRA21-1),carbohydrate antigen 125(CA125)],and immunoglobulin E(IgE)levels in the two groups were significantly lower than those before treatment,and those in the study group were significantly lower than those in the control group(P<0.05).The level of immunoglobulin A(IgA),CD_(4)^(+)/CD_(8)^(+),and the scores of the Functional Assessment of Cancer Therapy-Lung(FACT-L)in the two groups were significantly higher than those before treatment,and those in the study group were significantly higher than those in the control group(P<0.05).During the treatment,the incidence of adverse reactions in the study group was 34.55%,which was significantly lower than 54.55%in the control group(P<0.05).Conclusion Alectinib-targeted therapy combined with gemcitabine chemotherapy can effectively improve the short-term efficacy of patients with lung adenocarcinoma,reduce the risk of tumor proliferation and metastasis,promote immune system function and quality of life of patients,and it has good safety.