埃克替尼联合吉西他滨、顺铂化疗对晚期非小细胞肺癌患者血管新生和治疗获益的影响

Effect of icotinib plus gemcitabine and cisplatin chemotherapy on angiogenesis and treatment benefits in patients with advanced non-small cell lung cancer

目的:探讨埃克替尼联合吉西他滨、顺铂化疗对晚期非小细胞肺癌患者血管新生和治疗获益的影响。方法:采用回顾性研究方法,选取2018年1月至2020年12月萍乡市人民医院晚期非小细胞肺癌患者86例,按照治疗方法将患者分为观察组(n=43)、对照组(n=43)。对照组予以吉西他滨、顺铂化疗,观察组在对照组基础上给予埃克替尼治疗,均治疗12周。比较2组临床疗效、治疗期间不良反应及治疗前后血清血管新生因子[血管内皮生长因子(vascular endothelial growth factor,VEGF)、转化生长因子-β1(transforming growth factor-beta 1,TGF-β1)、基质金属蛋白酶-9(matrix metalloproteinase-9,MMP-9)]、肿瘤标志物[细胞角蛋白19片段21-1(cytokeratin 19 fragment antigen 21-1,CYFRA21-1)、糖类抗原125(carbohydrate antigen 125,CA125)、癌胚抗原(carcinoembryonic antigen,CEA)],治疗后随访2年,统计2组生存率。结果:观察组总有效率74.42%,明显高于对照组34.88%(P<0.01);与对照组比较,观察组治疗4周、12周后血清VEGF、TGF-β1、MMP-9、CYFRA21-1、CA125、CEA水平更低(P<0.05);观察组肝肾功能异常、白细胞减少、血小板减少发生率低于对照组(P<0.05)。观察组治疗后1年、2年生存率较对照组高(P<0.05)。结论:埃克替尼联合吉西他滨、顺铂化疗治疗非小细胞肺癌疗效显著、安全性高,能进一步抑制新生血管生成,提高治疗效益,延长生存周期。

OBJECTIVE To explore the effects of combining Icotinib with gemcitabine and cisplatin chemotherapy on angio⁃genesis and treatment outcomes in patients with advanced non-small cell lung cancer(NSCLC).METHODS Between January 2018 and December 2020,a total of 86 NSCLC patients were recruited and assigned into two groups of observation(n=43)and control(n=43).Control group received gemcitabine and cisplatin chemotherapy for 12 weeks while observation group had addi⁃tional icotinib dosing for 12 weeks.Comparison was conducted between two groups with regards to clinical efficacy,treatmentrelated toxic events,serum levels of angiogenic factors[vascular endothelial growth factor(VEGF),transforming growth factorbeta 1(TGF-β1),matrix metalloproteinase-9(MMP-9),tumor markers(cytokeratin 19 fragment antigen 21-1(CYFRA21-1),carbohydrate antigen 125(CA125)&carcinoembryonic antigen(CEA)],as well as survival rates during 2-year follow-ups.RESULTS The overall response rate was significantly higher in observation group than that in control group(74.42%vs.34.88%)(P<0.01).Additionally,observation group exhibited lower serum levels of VEGF,TGF-β1,MMP-9,CYFRA21-1,CA125 and CEA at Week 4/12 than those of control group(P<0.05).The incidence of abnormal hepatorenal function,leuko⁃penia and thrombocytopenia was also lower in observation group than control group(P<0.05).Furthermore,observation group demonstrated higher survival rates at Year 1/2 than control group(P<0.05).CONCLUSION The combination therapy of ico⁃tinib with gemcitabine and cisplatin demonstrates remarkable efficacy and excellent safety for NSCLC.Furthermore,it exerts inhibitory effects on angiogenesis,enhances treatment efficacy and prolongs overall survival.