贝伐珠单抗联合TP化疗方案治疗晚期NSCLC的疗效

Clinical efficacy of bevacizumab combined with TP chemotherapy regimen in the treatment of advanced NSCLC

目的观察贝伐珠单抗联合TP化疗方案治疗晚期非小细胞肺癌(NSCLC)的临床疗效。方法回顾性选取2020年1月-2022年12月滨州市中心医院收治的晚期NSCLC患者60例,依据用药方法不同分为TP化疗组(n=30)、联合化疗组(n=30)。TP化疗组患者采用TP化疗方案治疗,联合化疗组患者在TP化疗组基础上给予贝伐珠单抗注射液治疗,2组均以3周为1个周期,共治疗4个周期。比较2组近期疗效,化疗前后肿瘤标志物(癌胚抗原、糖类抗原125、细胞角蛋白19片段抗原21-1、神经元特异性烯醇化酶)、血管生成促进因子[碱性成纤维细胞生长因子(bFGF)、血管内皮生长因子(VEGF)]、免疫指标(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))、视觉模拟评分法(VAS)评分、生活质量评定量表(QOL)评分,不良反应,中位生存期,无进展生存期。结果联合化疗组疾病控制率为96.67%,高于TP化疗组的73.33%(χ^(2)=4.706,P=0.030)。化疗4个周期后,2组癌胚抗原、糖类抗原125、细胞角蛋白19片段抗原21-1、神经元特异性烯醇化酶、bFGF、VEGF水平低于化疗前,且联合化疗组低于TP化疗组(P<0.05或P<0.01);2组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)高于化疗前,CD8^(+)低于化疗前,且联合化疗组高/低于TP化疗组(P<0.01);2组VAS评分低于化疗前,QOL评分高于化疗前,且联合化疗组低/高于TP化疗组(P<0.01)。TP化疗组与联合化疗组不良反应发生率比较,差异无统计学意义(P>0.05)。联合化疗组中位生存期、无进展生存期长于TP化疗组(P<0.01)。结论贝伐珠单抗与TP化疗方案联合应用于晚期NSCLC的治疗,效果显著,能有效降低患者的肿瘤标志物水平,提高免疫功能,抑制肿瘤进展,并提升生活质量,可延长患者的生存期,且不会增加不良反应。

Objective To observe the clinical efficacy of bevacizumab combined with TP chemotherapy regimen in the treatment of advanced NSCLC.Methods A total of 60 patients with advanced NSCLC admitted to Binzhou Central Hospital from January 2020 to December 2022 were retrospectively selected,and they were divided into the TP chemotherapy group and the combination chemotherapy group by different medication,30 cases in each group.Patients in the TP chemotherapy group were treated with the TP chemotherapy regimen,and patients in the combination chemotherapy group were given bevacizumab injection on the basis of the TP chemotherapy group.The two groups were taken 3 weeks as a chemotherapy cycle,with a total of 4 cycles of chemotherapy.Recent efficacy,tumor markers(carcinoembryonic antigen,carbohydrate antigen 125,cytokeratin 19 fragment antigen 21-1,neuron specific enolase),angiogenesis-promoting factors(bFGF,VEGF),immunity indexes(CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)),VAS score,QOL score before and after chemotherapy,and incidence of adverse reactions,median survival,progression-free survival were compared between the two groups.Results The disease control rate in the combination chemotherapy group was 96.67%,which was higher than 73.33%in the TP chemotherapy group(χ^(2)=4.706,P=0.030).After 4 cycles of chemotherapy,levels of carcinoembryonic antigen,carbohydrate antigen 125,cytokeratin 19 fragment antigen 21-1,neuron specific enolase,bFGF and VEGF were lower than those before chemotherapy in the two groups,and the combination chemotherapy group were lower than those in the TP chemotherapy group(P<0.05 or P<0.01);CD3^(+),CD4^(+),CD4^(+)/CD8^(+)were higher than those before chemotherapy in the two groups,while CD8^(+)was lower than that before chemotherapy,and the combination chemotherapy group were higher/lower than those in the TP chemotherapy group(P<0.01);VAS score of the two groups was lower than that before chemotherapy,QOL score was higher than that before chemotherapy,and the combination chemotherapy group were lower/higher than those in the TP chemotherapy group(P<0.01).There was no statistically significant difference in the total incidence rate of adverse reactions between the TP chemotherapy group and the combination chemotherapy group(P>0.05).Median survival and progression-free survival in the combination chemotherapy group were longer than those in the TP chemotherapy group(P<0.01).Conclusion The efficacy of bevacizumab combined with TP chemotherapy regimen in the treatment of advanced NSCLC is remarkable,which can effectively reduce the levels of patients′tumor markers,promote immune function,inhibit tumor progression,and improve the quality of life,prolong the survival period,and do not increase the adverse reactions.