安罗替尼联合AN方案一线治疗晚期野生型肺腺癌的回顾性研究

A Retrospective Study on the First-line Treatment of Advanced Wild-type Lung Adenocarcinoma with Arotinib Combined with AN Regimen

目的:探讨安罗替尼联合AN方案一线治疗晚期野生型肺腺癌的临床效果。方法:将上饶市人民医院肿瘤科2020年2月—2022年2月收治的68例晚期野生型肺腺癌患者的临床资料进行回顾性分析,按治疗方案分作AN化疗组(n=35)、安罗替尼联合组(n=33)。比较两组近期疗效、肿瘤标志物水平及预后。结果:两组客观缓解率(ORR)比较,差异无统计学意义(P>0.05);安罗替尼联合组疾病控制率(DCR)为81.82%,高于AN化疗组的54.29%,差异有统计学意义(P<0.05)。治疗前,两组癌胚抗原(CEA)、血管内皮生长因子(VEGF)及细胞角蛋白19片段(CYFRA21-1)比较,差异均无统计学意义(P>0.05);治疗后,两组CEA、VEGF、CYFRA21-1较治疗前均降低,且安罗替尼联合组均低于AN化疗组(P<0.05)。安罗替尼联合组Ⅰ+Ⅱ级疲乏发生率高于AN化疗组(P<0.05);两组Ⅲ+Ⅳ级疲乏,Ⅰ+Ⅱ级与Ⅲ+Ⅳ级咯血、骨髓抑制、肝肾毒性、胃肠道反应及手足综合征比较,差异均无统计学意义(P>0.05)。经log-rank检验,安罗替尼联合组无进展生存期(PFS)、总生存期(OS)均长于AN化疗组(P<0.05)。结论:应用安罗替尼联合AN方案一线治疗晚期野生型肺腺癌具有一定疗效,肿瘤标志物水平获得改善,预后较好,且毒副反应在可控范围内。

Objective:To investigate the clinical effect of Anrotinib combined with AN regimen in the first-line treatment of advanced wild-type lung adenocarcinoma.Method:Clinical data of 68 patients with advanced wild-type lung adenocarcinoma admitted to Shangrao People's Hospital Department of Oncology from February 2020 to February 2022 were retrospectively analyzed,and divided into AN chemotherapy group(n=35)and Anrotinib combined group(n=33)according to treatment plan.The short-term efficacy,tumor marker level and prognosis of the two groups were compared.Result:There was no statistical significance in objective response rate(ORR)between the two groups(P>0.05);the disease control rate(DCR)in the Antirotinib combined group was 81.82%,which was higher than 54.29%in the AN chemotherapy group,the difference was statistically significant(P<0.05).There were no significant differences in carcino-embryonic antigen(CEA),vascular endothelial growth factor(VEGF)and cytokeratin 19 fragment(CYFRA21-1)between the two groups before treatment(P>0.05);after treatment,CEA,VEGF and CYFRA21-1 were decreased of the two groups compared with before treatment,and the Anrotinib combined group were lower than those in the AN chemotherapy group(P<0.05).The incidence of gradeⅠ+Ⅱfatigue in Anrotinib combined group was higher than that in AN chemotherapy group(P<0.05);there were no significant differences in gradeⅢ+Ⅳfatigue,gradeⅠ+Ⅱand gradeⅢ+Ⅳhemoptysis,myelosuppression,hepatorenal toxicity,gastrointestinal reaction and hand-foot syndrome between the two groups(P>0.05).log-rank test showed that progression-free survival(PFS)and overall survival(OS)in the Anrotinib combined group were longer than those in the AN chemotherapy group(P<0.05).Conclusion:The first-line treatment of advanced wild-type lung adenocarcinoma with Anrotinib combined with AN regimen has certain efficacy,the level of tumor markers is improved,the prognosis is good,and the toxic and side effects are controllable.