西黄胶囊联合白蛋白结合型紫杉醇三线及以上方案对晚期NSCLC的疗效及肿瘤标志物的影响

Efficacy of Xihuang capsules combined with albumin-bound paclitaxel in the third-line and beyond treatment of advanced non-small cell lung cancer and its impact on tumor biomarkers

目的 分析西黄胶囊联合白蛋白结合型紫杉醇三线及以上方案治疗晚期非小细胞肺癌(NSCLC)患者的效果及对肿瘤标志物的影响。方法 选取2020年3月至2021年9月收治的60例确诊为晚期NSCLC并且愿意接受治疗的患者为研究对象,将其中30例白蛋白结合型紫杉醇治疗的患者作为对照组,30例西黄胶囊联合白蛋白结合型紫杉醇治疗的患者作为研究组,将两组患者的客观有效率(objective response rate, ORR)、疾病控制率(disease control rate, DCR)、中位无进展生存(median progression-free survival, mPFS)、总生存期(overall survival, OS)情况进行对比,分析两组患者血清肿瘤标志物糖类抗原125(carbohydrate antigen 125, CA125)、癌胚抗原(carcinoembryonic antigen, CEA)、糖类抗原199(carbohydrate antigen 199, CA199)、细胞角蛋白片段19(cytokeratin fragment 21-1, CYFRA 21-1)变化情况,观察治疗期间不良反应发生情况。结果 研究组患者ORR值36.67%、DCR值76.67%、mPFS值(6.35±2.02)个月、OS值(9.77±3.13)个月,对照组患者ORR值13.33%、DCR值50.00%、mPFS值(3.11±0.94)个月、OS值(5.79±1.98)个月,两者ORR、DCR、mPFS和OS值相比差异均有统计学意义(P<0.05)。与对照组治疗后比较,研究组患者治疗后CA125[(51.34±14.72) U/mL vs.(75.63±18.41)U/mL,t=5.644,P=0.000]、CEA [(19.73±3.68)ng/mL vs.(24.51±5.22)ng/mL,t=4.099,P=0.000]、CA199 [(21.33±3.14)U/mL vs.(24.38±4.15)U/mL,t=3.210,P=0.002]、CYFRA 21-1[(2.46±0.37)ng/mL vs.(3.22±0.78)ng/mL,t=21.787,P=0.000]水平显著下降。与对照组相比,研究组患者毛细血管增生症和甲状腺功能减退的发生率更高(P<0.05),中性粒细胞减少、胃肠道反应的发生率更低(P<0.05),脱发、神经系统损伤、肝肾毒性和发热的发生率基本无差别(P>0.05)。结论 西黄胶囊联合白蛋白结合型紫杉醇三线及以上方案治疗晚期NSCLC患者具有更好的近期和远期疗效,并且可以明显降低血清中肿瘤标志物水平,延缓肿瘤疾病进展,且毒性小、安全性良好。

Objective To analyze the efficacy of Xihuang capsule combined with albumin bound paclitaxel in the treatment of advanced non-small cell lung cancer(NSCLC)patients and its impact on tumor markers.Methods Sixty confirmed advanced NSCLC patients,who willing to undergo treatment between March 2020 and September 2021,were selected as the study subjects.Among them,30 patients treated with albumin-bound paclitaxel were allocated to the control group,while the other 30 patients treated with a combination of Xihuang capsules and albumin-bound paclitaxel constituted the study group.The two groups were compared for objective response rate(ORR),disease control rate(DCR),median progression-free survival(mPFS),and overall survival(OS).Serum tumor biomarkers including carbohydrate antigen 125(CA125),carcinoembryonic antigen(CEA),carbohydrate antigen 199(CA199),and cytokeratin fragment 21-1(CYFRA 21-1)were analyzed for changes.Adverse reactions during treatment were also observed.Results In the study group,the ORR was 36.67%,DCR was 76.67%,mPFS was(6.35±2.02)months,and OS was(9.77±3.13)months.In the control group,the ORR was 13.33%,DCR was 50.00%,mPFS was(3.11±0.94)months,and OS was(5.79±1.98)months.Significant differences were observed between the two groups in terms of ORR,DCR,mPFS,and OS(P<0.05).After treatment,significant reductions were noted in serum levels of CA125[(51.34±14.72)U/mL vs.(75.63±18.41)U/mL,t=5.644,P=0.000],CEA[(19.73±3.68)ng/mL vs.(24.51±5.22)ng/mL,t=4.099,P=0.000],CA199[(21.33±3.14)U/mL vs.(24.38±4.15)U/mL,t=3.210,P=0.002],and CYFRA 21-1[(2.46±0.37)ng/mL vs.(3.22±0.78)ng/mL,t=21.787,P=0.000]in the study group compared to the control group(P<0.05).Additionally,the study group had a higher incidence of capillary proliferation and hypothyroidism(P<0.05),lower incidence of hematologic and gastrointestinal toxicity(P<0.05),and comparable incidence of hair loss,neurological impairment,hepatic and renal toxicity,and fever(P>0.05)compared to the control group.Conclusion Xihuang capsules combined with albumin-bound paclitaxel as a third-line and beyond treatment for advanced NSCLC patients shows superior short-term and long-term efficacy.It significantly lowers serum tumor biomarker levels,delays tumor progression,and exhibits a favorable safety profile with minimal toxicity.