同步放化疗联合巩固化疗治疗晚期肺癌的临床疗效

Clinical Efficacy of Concurrent Chemoradiotherapy Combined with Consolidation Chemotherapy in Treatment of Advanced Lung Cancer

目的分析同步放化疗联合巩固化疗治疗晚期肺癌的临床疗效。方法收集2019年1月至2020年12月淮北矿工总医院肿瘤放疗中心收治的80例晚期肺癌患者的临床资料,根据治疗方法不同分为观察组和对照组,各40例。对照组予以序贯放化疗,观察组予以同步放化疗联合多西他赛(60 mg/m^(2))和顺铂(75 mg/m^(2))巩固化疗,4个周期后对比两组的近期疗效、血清肿瘤标志物[细胞角蛋白19片段抗原21-1(CYFRA21-1)、糖类抗原(CA)19-9、癌胚抗原(CEA)及CA125]表达及安全性。结果治疗后,观察组的近期总有效率高于对照组[85.00%(34/40)比62.50%(25/40)](χ^(2)=8.117,P=0.044)。治疗4个周期后,两组血清CYFRA21-1、CA19-9、CEA及CA125表达均低于治疗前(P<0.01),且观察组血清CYFRA21-1、CA19-9、CEA及CA125表达低于对照组[(6.09±1.33)μg/L比(9.41±1.47)μg/L、(15.2±2.1)μg/L比(33.8±4.7)μg/L、(58.76±3.77)μg/L比(75.73±3.53)μg/L、(60.6±4.1)kU/L比(105.2±5.4)kU/L](P<0.01)。两组骨髓抑制、周围神经毒性、恶心呕吐、食欲降低、白细胞计数降低、放射性肺炎、放射性食管炎、脱发的发生率比较差异无统计学意义(P>0.05)。结论同步放化疗联合巩固化疗治疗晚期肺癌的临床效果显著,有助于提升近期疗效,降低血清肿瘤标志物表达,且安全性可靠。

Objective To analyze the clinical efficacy of concurrent chemoradiotherapy combined with consolidation chemotherapy in the treatment of advanced lung cancer.Methods The clinical data of 80 patients with advanced lung cancer admitted to the Radiotherapy Center of Huaibei Miners General Hospital from Jan.2019 to Dec.2020 were collected,and according to the treatment methods,they were divided into an observation group and a control group,40 cases each.The control group received sequential chemoradiotherapy,and the control group received concurrent chemoradiotherapy combined with onsolidation chemotherapy of docetaxel(60 mg/m^(2))and cisplatin(75 mg/m^(2)).The short-term efficacy,expression of serum tumor markers[cytokeratin 19 fragment antigen 21-1(CYFRA21-1),carbohydrate antigen(CA)19-9,carcinoembryonic antigen(CEA)and CA125],as well as the safety were compared between the two groups after 4 cycles.Results After treatment,the short-term total effective rate of the observation group was higher than that of the control group[85.00%(34/40)vs 62.50%(25/40)](χ^(2)=8.117,P=0.044).After 4 cycles of treatment,the expressions of CYFRA21-1,CA19-9,CEA and CA125 in serum of the two groups were lower than those before treatment(P<0.01).The expressions of CYFRA21-1,CA19-9,CEA and CA125 in the observation group were lower than those in the control group[(6.09±1.33)μg/L vs(9.41±1.47)μg/L,(15.2±2.1)μg/L vs(33.8±4.7)μg/L,(58.76±3.77)μg/L vs(75.73±3.53)μg/L,(60.6±4.1)kU/L vs(105.2±5.4)kU/L](P<0.01).There was no significant difference in the incidence of bone marrow suppression,peripheral neurotoxicity,nausea and vomiting,decreased appetite,decreased white blood cell count,radiation pneumonitis,radiation esophagitis and alopecia between the two groups(P>0.05).Conclusion Simultaneous radiotherapy and chemotherapy combined with consolidation chemotherapy have significant clinical effects in the treatment of patients with advanced lung cancer,which can help improve their short-term efficacy,reduce the expression of serum tumor markers,with reliable safety.