重组人血管内皮抑制素联合奥希替尼治疗晚期非小细胞肺癌的疗效及预后分析

The efficacy and prognosis analysis of recombinant human endostatin combined with ocitinib in the treatment of advanced non-small cell lung cancer

目的:分析重组人血管内皮抑制素联合奥希替尼对晚期非小细胞肺癌(non-small cell lung cancer, NSCLC)患者疗效及预后的影响。方法:选择2020年06月至2022年02月医院就诊的晚期NSCLC患者92例,采用随机数字表法将其分成对照组与研究组,各46例。对照组接受奥希替尼治疗,研究组在对照组的基础上接受重组人血管内皮抑制素治疗。21 d为1个周期,2组均治疗3个周期评估效果。对比2组临床疗效、健康状况、生活质量、肿瘤标志物、肿瘤相关蛋白因子及不良反应,随访1年,记录2组无进展生存期(PFS)。结果:研究组客观缓解率(50.00%)高于对照组(26.09%)(P<0.05),研究组疾病控制率(76.09%)高于对照组(54.35%)(P<0.05)。治疗3个周期后,2组卡氏功能状态(KPS)评分、癌症治疗功能性量表(FACT-L)评分均升高(P<0.05),且研究组更高(P<0.05)。治疗3个周期后,2组血清细胞角蛋白19片段(CYFRA21-1)、鳞状细胞癌抗原(SCC)、糖类抗原50(CA50)水平均降低(P<0.05),且研究组更低(P<0.05)。治疗3个周期后,2组磷酸酶张力蛋白同源物(PTEN)相对表达量均升高(P<0.05),且研究组更高(P<0.05);治疗3个周期后,2组血黏蛋白(MUC1)相对表达量均降低(P<0.05),且研究组更低(P<0.05)。2组Ⅰ-Ⅳ级消化道反应、血小板下降、肝肾功能损伤、中性粒细胞减少不良反应总发生率比较差异无统计学意义(P>0.05)。随访1年,2组均失访1例,随访率为97.83%,研究组中位PFS为8.97(95%CI:6.13~11.35)个月,对照组中位PFS为6.53(95%CI:3.85~9.61)个月,研究组PFS曲线优于对照组(P<0.05)。结论:重组人血管内皮抑制素联合奥希替尼治疗晚期NSCLC患者疗效确切,可降低肿瘤标志物水平,改善患者生活质量,调节肿瘤相关蛋白因子表达,安全可靠,且可延长患者PFS。

Objective:To analyze the effect of recombinant human endostatin combined with ocitinib on the efficacy and prognosis of patients with advanced non-small cell lung cancer(NSCLC).Methods:A total of 92 patients with advanced NSCLC treated in hospital from June 2020 to February 2022 were selected and divided into control group and study group with 46 cases in each group by random number table method.The control group received ocitinib treatment,and the study group received recombinant human endostatin treatment based on the control group.21 days was 1 cycle,and 2 groups were treated for 3 cycles to evaluate the effect.The clinical efficacy,health status,quality of life,tumor markers,tumor-related protein factors and adverse reactions of the two groups were compared.The progression-free survival(PFS)of the two groups was recorded during 1-year follow-up.Results:The objective remission rate of the study group(50.00%)was higher than that of the control group(26.09%)(P<0.05).The disease control rate of the study group(76.09%)was higher than that of the control group(54.35%)(P<0.05).After 3 cycles of treatment,Karnofsky(KPS)scores and functional assessment of cancer therapy-lung(FACT-L)scores were increased in 2 groups,and higher in the study group(P<0.05).After 3 cycles of treatment,serum cytokeratin 19 fragment(CYFRA21-1),squamous cell carcinoma antigen(SCC)and carbohydrate antigen 50(CA50)levels in 2 groups were decreased(P<0.05),and those in the study group were lower(P<0.05).After 3 cycles of treatment,the relative expression of phosphatase tensin homolog(PTEN)was increased in 2 groups(P<0.05),and higher in study group(P<0.05).After 3 cycles of treatment,the relative expression of MUC1 was decreased in both groups(P<0.05),and was lower in the study group(P<0.05).There was no difference in the total incidence of gradeⅠtoⅣadverse reactions such as digestive tract reaction,thrombocytopenia,liver and kidney function injury and neutropenia between 2 groups(P>0.05).The follow-up rate was 97.83%.The median PFS of the study group was 8.97(95%CI:6.13~11.35)months and that of the control group was 6.53(95%CI:3.85~9.61)months.The PFS curve of the study group was better than that of the control group(P<0.05).Conclusion:Recombinant human endostatin combined with ocitinib is effective in the treatment of advanced NSCLC patients,which can reduce the level of tumor markers,improve the quality of life of patients,regulate the expression of tumor-related protein factors,and is safe and reliable,and can prolong the PFS of patients.