Long-term survival of more than 3 years among patients with advanced non-small cell lung cancer treated with chemotherapy

AIM: To evaluate the prognostic factors of long-term survival of more than 3 years in patients with advanced non-small cell lung cancer(NSCLC). METHODS: We retrospectively analyzed the records of 474 patients with advanced ⅢB/Ⅳ NSCLC who received chemotherapy as initial treatment between September 2002 and March 2007.RESULTS: The median survival time(MST) was 12.5 mo and the 3 year and 5 year survival rates were 14.6% and 5.3%, respectively. Long-term survival of more than 3 and 5 years was observed in 65 and 16 patients, respectively. The MST for the 65 patients was61.5 mo(range, 60.1-81.0 mo). In the 474 patients, a good performance status(PS), female sex, non-smoking status and adenocarcinoma histology were significantly associated with a favorable outcome. Furthermore, female sex, a good PS, non-smoking status and adenocarcinoma histology were significantly correlated with longterm survival of more than 3 years and most of these patients(89.2%, 58/65) received epidermal growth factor receptor-tyrosine kinase inhibitors as any line treatment. Survival analysis of long-term survivors showed that a PS of 0 was an independent prognostic factor for predicting favorable outcomes. CONCLUSION: Our results suggest that a good PS and adenocarcinoma histology play an important role in long-term survival of more than 3 years. A PS of 0 was an independent prognostic factor for predicting favorable outcomes in patients with advanced NSCLC who survived for more than 3 years.

Shenqi Fuzheng injection combined with GP chemotherapy in the treatment of advanced non-small cell lung cancer： a meta-analysis

Objective： To evaluate the clinical efficacy of Shenqi Fuzheng injection combined with gemcitabine plus cisplatin（GP） in the treatment of advanced non-small cell lung cancer （NSCLC）. Methods： we performed a systematicsearch in the electronic databases such as Cochrane Library, Pubmed, Embase, Chinese Journal Full-text Database,Chinese Biomedical Literature Database, Chinese Science and Technology Periodical Full-text Database andWanfang Database up to 30 January 2017. Randomized controlled trials （RCT） of Shenqi Fuzheng Injectioncombined with GP chemotherapy in the treatment of advanced NSCLC were searched, and all the RCTs wereconducted on methodological quality assessment. Data extraction and data analysis were according to standards ofCochrane systematic review. Results： Eight trials were included including a total of 701 patients. Meta-analysisresults： Shenqi Fuzheng injection combined with GP chemotherapy could significantly improve the functionalstatus of patients with NSCLC （OR = 3.44, 95% CI [2.26, 5.25], P 〈 0.0001） and clinical treatment efficacy （OR =（OR = 0.31, 95%CI [0.20, 0.47], P 〈 0.0001. The rate of leukopenia （OR = .31, 95%CI [0.20,0.47], P 〈 0.0001）,thrombocytopenia （OR = 0.58, 95%CI [0.37, 0.91], P = 0.020）, hemoglobin decline （（OR = 0.31, 95%CI [0.16,0.59], P = 0.0004） and incidence of gastrointestinal reactions （OR = 0.58,P 〈 0.05） could be reduced. Conclusion：Shenqi Fuzheng injection combined with GP chemotherapy in the treatment of advanced NSCLC obtainedsignificantly clinical efficacy. The quality of the literature incorporated is low, the conclusion requires high-qualityresearch to further prove.

EFFECT OF NEOADJUVANT CHEMOTHERAPY USING PACLITAXEL COMBINED WITH CARBOPLATIN ON ADVANCED NON-SMALL CELL LUNG CANCER

Objeetive： To assess the therapeutic effectiveness of preoperative neoadjuvant chemotherapy using a combination of paclitaxel and carboplatin on local advanced non-small cell lung cancer （NSCLC）. Methods： Twenty-five patients with advanced NSCLC were treated with paclitaxel and carboplatin for 2 to 4 cycles before undergoing tumor resection and then postoperative chemotherapy/radiotherapy therapy for 2 to 4 cycles. Results： Following neoadjuvant chemotherapy, the most prominent side-effect was bone marrow restraint. The overall response rate of preoperative chemotherapy was 56%. The mean survival time was 26.5 months, with 1-, 2- and 5-year survival rates of 55%, 25%, and 16%, respectively. All NSCLC patients survived the perioperative period. Conclusion： Preoperative neoadjuvant chemotherapy combining paclitaxel and carboplatin produced minimal side-effect while increasing the probability that advanced NSCLC patients would be able to undergo surgery thus improving their prognosis.

Effect of Astragalus Injection Combined with Chemotherapy on Qual ity of Life in Patients with Advanced Non-small Cell Lung Cancer

Objective: To observe the effect of Astragalus injection (AI) combined with chemotherapy on quality of life (QOF) in patients with advanced non-small cell lung caner (NSCLC). Methods: Sixty NSCLC patients were randomly divided into the treated group (n=30,treated with AI combined with chemotherapy) and the control group (n=30, treated with chemotherapy alone). Chemotherapy of MVP protocol was applied to both groups. AI was supplemented to the treated group by intravenous dripping 60 ml per day. Treatment of 21-28 days consisted one treatment cycle, and 2-3 cycles were applied. WResults: The effective rate in the treated group was 40.0% and in the control group was 36.7%, the mean remission rate in them being 5.4 month s and 3.3 months, the median survival period 11 month and 7 month and the 1-year survival rate 46.75% and 30.0%, respectively, the difference of these indexes between the two groups were all significant (P<0 05). Moreover, the clinical improving rate and QOF elevation rate in the treated group was 80.4% and 43.3%, as compared with those in the control group (50.0% and 23.3% respectively), the different was also significant (P<0 01). Conclusion: AI combined with chemotherapy can significantly improve the QOF in NSCLC patients of advanced stage.

Therapeutic Effects of Kanglaite Injection Combined with Chemotherapy on Advanced Non-small-cell Lung Cancer

The objective of this study was to study the therapeutic effect of Kanglaite injection combined with chemotherapy in the treatment of late-stage nonsmall-cell lung cancer(NSCLC)and also to observe the effect of the combination treatment on immune function.92 patients with advanced stage of NSCLC who admitted to First Hospital of Zibo city hospital from May 2017 to October 2018 were randomly divided into experimentagroup and control group,with 46 cases,respectively.The control group was treated with chemotherapy only while the experimental group was treated with Kanglaite injection combined with chemotherapy which was the basic treatment for patients,and the total treatment effective rate,adverse reaction rate,and immune index of the treatments on two groups were compared.The total treatment effective rate of the experimental group was 80.43%,which was significantly higher than that of the control group,which was 63.04%.The incidence of adverse reactions in the experimental group was 36.96%,which was lower than that of the control group(78.26%).The immune indexes of the experimental group(CD3+,CD4+,IgG,and IgA)were better than that of the control group,respectively.The differences between the two groups were statistically significant(P<0.05).During the chemotherapy of late-stage or advanced NSCLC,the addition use of Kanglaite injection has a significant effect on improving tumor control and reducing the side effects of chemotherapy,and helps to improve the immune function of patients;thus,it is worth promoting.

Effects of Yiqi Gu Ben Decoction combined with DC chemotherapy on serum tumor markers, inflammatory factors and immune function in patients with locally advanced non-small cell lung cancer

Objective: To investigate the effects of Yiqi Gu decoction combined with DC chemotherapy on serum tumor markers, inflammatory factors and immune function in patients with locally advanced non-small cell lung cancer. Methods: A total of 95 patients with locally advanced non-small cell lung cancer were selected as the research objects, according to the random data table they were divided into control group (n=48) and observation group (n=47), patients in the control group were given DC chemotherapy, On the basis of this treatment, the patients in the observation group were given Yiqi Gu decoction treatment, Comparison of the levels of serum tumor markers [antigen (CEA) and carbohydrate antigen 19-9 (CA19-9)], inflammatory factor [C reactive protein (CRP) and tumor necrosis factor-α (TNF-α)] and immune function (CD3+, CD4+, CD8+, CD4+/CD8+)Results: Before treatment, there were no significant difference in the levels of CEA, CA19-9, CRP, TNF-α, CD3+, CD4+, CD8+, CD4+/CD8+ between the two groups;After treatment, the CEA, CA19-9, CRP, TNF-α, CD8+ levels of two groups were significantly lower than those in the same group before treatment, and the decreased range in observation group was significantly higher than the control group, moreover the levels after treatment were obviously lower than control group;After treatment, the levels of CD3+, CD4+, CD4+/CD8+ in the observation group were (64.72±5.25)% , (39.51±5.14)% and (1.35±0.27), which were significantly higher than the same group before treatment, and significantly higher than the control group [(58.57±5.09)%, (31.34±5.06)%, (1.14±0.33)], differences were statistically significant. Conclusion: DC chemotherapy combined with Yiqi Guben Decoction in the treatment of locally advanced non-small cell lung cancer, can effectively reduce the serum tumor marker levels, decrease inflammatory stress, improve immune function, has an important clinical value.

Efficacy and safety of albumin-bound paclitaxel in treating recurrent advanced non-small-cell lung cancer

Objective： To observe the efficacy and safety of albumin-bound paclitaxel （ABP） monotherapy in treating recurrent advanced non-small-cell lung cancer （NSCLC）. Methods： We retrospectively analyzed the short-term efficacy and toxicities of ABP monotherapy in treating 21 patients who had previously undergone multiple cycles of therapy for their advanced NSCLC in our hospital since 2010. The treatment-related survival was also analyzed. Results： Of these 21 patients, the best overall response was partial response （PR） in 6 patients （28.6%）, stable disease （SD） in I0 patients （47.6%）, and progressive disease （PD） in 5 patients （23.8%）. The overall response rate （ORR） was 28.6% and the disease control rate （DCR） （PR ＋ SD） was 76.2%. The median progression-flee survival （PFS） was 4.0 months （95% CI, 5.0-7.0 months）. The main grade 3/4 toxicities included neutropenia （11.1%）, peripheral nerve toxicity （5.6%）, muscle and joint aches （5.6%）, and fatigue （5.6%）. Conclusions： The ABP monotherapy can achieve good objective response in advanced NSCLC patients who have previously received multiple cycles of treatment and be well tolerated.

Comparison of efficacy and toxicity between gemcitabine plus cisplatin and plus carboplatin in first-line treatment of advanced non-small cell lung cancer

Objective: To compare the efficacy and toxicity between gemcitabine plus cisplatin and plus carboplatin in first-line treatment of advanced non-small cell lung cancer (NSCLC). Methods: Gemcitabine 1000 mg/m2 iv, d1, 8; cisplatin 75 mg/m2 iv, d1, or 25 mg/m2 iv, d1-3; carboplatin AUC = 5 iv, d1; repeated every 21 days. Results: All 76 cases were available for objective response. Gemcitabine + cisplatin (GCis) group: among 33 cases, CR 1 case, PR 13 cases, MR 3 cases, SD 7 cases, PD 9 cases, response rate, disease control rate, time to progress (TTP), median survival time (MST) and 1-, 2-year survival rates were 42.42% (14/33), 72.73% (24/33), 5 months, 14 months and 66.67% (22/33), 12.12% (4/33), respectively; Gemcitabine + carboplatin (GCarb) group: among 43 cases, PR 13 cases, MR 11 cases, SD 7 cases, PD 12 cases, the results while comparing with those of GCis group were 30.23% (13/43), 72.09% (31/43), 4 months, 11 months and 48.84% (21/43), 2.33% (1/43), respectively. Among them, only MST between the two groups had significant statistic difference (χ2 = 2.45, P = 0.017). Mild to modest myelo-suppression as well as nausea and vomiting were observed. Conclusion: Both GCis and GCarb regimens had active and well-tolerated toxicity for advanced NSCLC. Cisplatin-based chemotherapy yields a substantial effective advantage over carboplatin-based regimens. Therefore, carboplatin and cisplatin are not equal-active and that cisplatin-based doublet regimens should remain the standard first-line therapy for patients with advanced NSCLC with good performance status.

Endostar combined GC in the treatment of advanced non-small cell lung cancer:a case report

A 43-year-old female with a 3-month history of paroxysmal irritating cough presented progressive chest tightness and shortness of breath.Laboratory data showed elevated carcino-embryonic antigen(CEA).Further imaging studies revealed a soft tissue mass shadow was in right middle lobe lung with mediastinal and sub-carinal lymph nodes enlarged.Biopsy diagnosis:moderately and poorly differentiated adenocarcinoma of the lung.Clinical diagnosis:central non-small cell lung cancer(NSCLC) of right middle lobe(CIVT4N2M1),lung adenocarcinoma G2-3,malignant pleural effusion,pericardial effusion,hilar and mediastina lymph node metastases.After 4 cycles of endostar plus GC therapy,imaging studies revealed showed soft tissue mass in right middle lobe disappeared,and evaluation of short-term result was complete remission(CR).PFS has been seven months till now.Therefore,this report provided strong evidence that endostatin combined GC treatment for advanced NSCLC is safe and effective,which can prolong survival and improve quality of life.

Long-term results of paclitaxel plus cisplatin with concurrent radiotherapy for loco-regional esophageal squamous cell carcinoma

AIM To evaluate the long-term effectiveness and late toxicities of paclitaxel(PTX) plus cisplatin(DDP) with concurrent radiotherapy for locally advanced esophageal squamous cancer.METHODS Between 2008 and 2011, 76 patients were enrolled in a phase Ⅱ study on the treatment of loco-regionally advanced esophageal cancer with radiotherapy(68.4 Gy/44 fractions or 61.2 Gy/34 fractions) combined with 4-cycle chemotherapy consisting of DDP(25 mg/m^2 per day for 3 d) and PTX(175 mg/m^2 for 3 h). The primary endpoints were overall survival and progression-free survival, and the secondary endpoints were toxicity and the treatment failure pattern.RESULTS A total of 76 patients were enrolled in this study, of whom 63.2% finished the whole regimen. The 5-year survival rates for the per-protocol population and intent-to-treat population were 25.4% and 26.4%, respectively, and the median survival rates were 23.7 mo and 28.5 mo, respectively. Grade 3 or 4 late toxicity was observed in only one patient(heart failure). In log-rank analysis, the pretreatment stage(stage Ⅱ + Ⅲ: 36.1 mo vs stage Ⅳ: 14.9 mo) and the completed cycle(1-3 cycles: 16.1 mo vs 4 cycles: 35.5 mo) were significant prognostic factors(P = 0.037 < 0.05 and P = 0.013 < 0.05).CONCLUSION Radiotherapy combined with chemotherapy consisting of PTX and DDP is a safe and effective definitive treatment for loco-regionally advanced esophageal squamous cancer.

Clinical characteristics and pathogenic analysis of lower respiratory tract infections in advanced lung cancer patients with different treatment modalities

Objective:To clarify the clinical characteristics and pathogenic analysis after lower respiratory tract infection in patients with advanced lung cancer under different treatments.Methods:A retrospective analysis was adopted to collect 94 cases of patients with advanced lung cancer combined with lower respiratory tract infection from January 1,2018 to December 1,2020.Seventy-four cases were male and 20 cases were female.According to the different treatments,the patients were divided into 43 cases in the chemotherapy group and 51 cases in the chemoradiotherapy group.The pathogenic and serological indexes were compared between the two groups to provide ideas for the application of antibiotics.Results:In the comparison of general clinical data,the chemotherapy group had a shorter hospital stay than the chemoradiotherapy group and a higher body mass index level than the chemoradiotherapy group(p<0.05).In the comparison of serological indicators,procalcitonin,high-sensitive Creactive protein,erythrocyte sedimentation rate,and neutrophil percentage were lower in the chemotherapy group,and the lymphocyte was higher than that in the chemoradiotherapy group(p<0.05).There was no difference in hemoglobin,albumin,creatinine,and alanine transaminase between the two groups(p>0.05).In the comparison of pathogenicity,the chemotherapy group was more likely to have combined viral infections,while the chemoradiotherapy group was more likely to have Gram-negative bacterial infections(p<0.05).There was no difference between the two groups in terms of fungal infections(p>0.05).Besides,the chemoradiotherapy group was more likely to have combined infections(p>0.05).Conclusion:Patients with advanced lung cancer treated with chemoradiotherapy have a relatively poor prognosis after developing lower respiratory tract infections and are more likely to have mixed infections.Antibiotics need to be applied as early as possible.The common pathogens should be covered.Antiviral and antifungal drugs can be added as appropriate,and drug sensitivity tests should be completed as early as possible.

A pilot study of weekly docetaxel chemotherapy combined with regional hyperthermia for pretreated stage Ⅲ non-small cell lung cancer

Objective： To evaluate the feasibility and therapeutic effect of chemotherapy combined with regional radio frequency hyperthermia for pretreated locally advanced non-small cell lung cancer. Methods： 29 patients with stage Ⅲb non- small cell lung cancer were enrolled in present study, administered chemotherapy up to 4 cycles and radio frequency hyperthermia up to 32 times. The primary end points were grade 3, 4 hematological or non-hematological toxicities and progression free survival, the secondary end points were response rate, tumor control rate and overall survival. Method of Kaplan-Meier was used to do the survival analysis. Results： 21 patients completed whole treatment. The most common grade 3, 4 toxicity was neutropenia （24.1%）. Median progression free survival was 4 months （range 0-13 months）, one year progression free survival rate was 10.3%, Overall response rate was 25.9%, tumor control rate was 66.6%. Median overall survival was 11 months （range 2-18^＊ months）, one year overall survival rate was 44.8%. Conclusion： Treatment of chemotherapy in conjunction with regional hyperthermia was safe and well tolerant, and it showed an impressive tumor control rate and an acceptable one year progression free survival.

Feasibility of cetuximab and chemoradiotherapy combination in Chinese patients with unresectable stage Ⅲ non-small cell lung cancer:a preliminary report

Objective： In recent years, the combination of cetuximab and chemoradiotherapy （CRT） has been used to treat stage III non-small cell lung cancer （NSCLC）; however, limited data are available for Chinese patients. Herein, we report preliminary data from a phase I/II study testing the combination of cetuximab with inductive chemotherapy, followed by concurrent CRT （CCRT） in Chinese patients with stage III NSCLC. Methods： Eligibility criteria were Zubrod performance status （PS） 0-1, forced expiratory volume in 1 second （FEV1） 〉_1.2 L and adequate organ function. Enrolled patients received weekly cetuximab （initial dose of 400 mg/m2 on day 1 of week 1 and a maintenance dose of 250 mg/m2 on week 2 to the end of CCRT） with cisplatin/vinorelbine （NP） chemotherapy （every 3 weeks for 2 cycles from week 2, followed by two cycles of concomitant NP chemotherapy and intensity-modulated thoracic radiotherapy （TRT） （60-66 Gy/2 Gy）. The primary endpoints were toxicity and feasibility. All patients received positron emission tomography- computerized tomography （PET-CT） scans within the 2 weeks prior to enrollment. Univariate analyses were used to assess the correlation between SUV-T, SUV-N, SUV-TOTAL, gender, age, histology, tumor-node- metastasis （TNM） stage, PS and smoking status and survival. Survival curves were generated for different populations using the Kaplan-Meier method and compared using a log-rank test. Results： Seventeen patients were enrolled and 16 completed the full regime. The overall response rate （ORR） was 58.8% and 82.3% after the induction and CCRT phases, respectively. With a median follow-up duration of 27.6 months, the median survival was 27.6 months [95% confidence interval （CI）： 11.3-43.9 months] with 1- and 2-year survival rates of 88.2% （95% CI, 60.6-96.9%） and 58.8% （95% CI, 60.6-77.8%）, respectively. Three patients remain progression-free to date, and the median progression-free survival （PFS） was 13.5 months （95% CI, 6.8-20.2 months）. No treatment-related death occurred; however, 76% of the patients experienced grade 3＋ adverse events （AEs）, including nansea/vomiting, intestinal obstruction, and esophagitis （〈6%）, while other AEs were mostly of hematological nature （71%）. The cut-off values for SUV-T and SUV-TOTAL were 11 and 20, respectively. Univariate analyses revealed SUV-TOTAL （P=0.027）, SUV-T （P=0.025）, and PS （P=0.006） as potential survival predictors, with a hazard ratio （HR） of 3.4, 3.7, and 9.9, respectively. Conclusions： The combination of cetuximab with induction chemotherapy followed by CCRT appears feasible and promising. Local and locoregional maximal SUVs, defined by 18F-FDG PET-CT scanning, may represent a prognostic indicator for long-term survival for these patients, which warrants further study.

化疗与贝伐珠单抗联合治疗晚期非小细胞肺癌的效果与安全性分析

目的 分析化疗联合贝伐珠单抗治疗晚期非小细胞肺癌(NSCLC)的效果和安全性。方法 90例晚期NSCLC患者随机分为两组,对照组给予常规化疗,观察组在对照组基础上给予贝伐珠单抗治疗,比较两组的治疗效果与安全性。结果 治疗后,观察组的治疗总有效率高于对照组,血清CEA、 CA125、 VEGF水平均低于对照组(P <0.05)。两组的各项不良反应发生率比较,差异均无统计学意义(P>0.05)。结论 化疗联合贝伐珠单抗联合治疗晚期NSCLC的效果显著,安全性高。

理肺解毒益髓汤对晚期肺癌化疗的增效减毒作用及其机制研究

目的:探究理肺解毒益髓汤对晚期肺癌化疗的增效减毒作用及其机制。方法:将2021年1月—2022年3月河北省中医院呼吸一科收治的80例晚期肺癌化疗患者依据随机数字表法分为对照组(n=40)和观察组(n=40)。对照组进行常规化疗,观察组则在对照组的基础上加用理肺解毒益髓汤。比较两组临床疗效、毒副反应发生率、治疗前后生存质量[健康调查量表36(SF-36)]、免疫因子[白细胞介素(IL)-4、IL-6、IL-10、IL-17及γ干扰素(IFN-γ)]及外周血循环肿瘤细胞数。结果:观察组总有效率显著高于对照组,毒副反应发生率均显著低于对照组,差异均有统计学意义(P<0.05);治疗前,两组SF-36评分、免疫因子及外周血循环肿瘤细胞数比较,差异均无统计学意义(P>0.05);治疗后观察组SF-36评分、IFN-γ水平均显著高于对照组,IL-4、IL-6、IL-10、IL-17均显著低于对照组,外周血循环肿瘤细胞数少于对照组,差异均有统计学意义(P<0.05)。结论:理肺解毒益髓汤在晚期肺癌化疗患者中的增效减毒作用突出,可显著改善患者的生存质量,可能是通过调节免疫因子发挥作用。

重组人血管内皮抑制素注射液联合GP化疗方案治疗晚期NSCLC的可行性

目的观察重组人血管内皮抑制素注射液联合GP化疗方案治疗晚期非小细胞肺癌(NSCLC)的可行性。方法回顾性选取2020年5月—2022年12月皖北煤电集团总医院肿瘤内科收治的晚期NSCLC患者80例,将采用GP化疗方案治疗者纳入GP化疗组(n=40),重组人血管内皮抑制素注射液联合GP化疗方案治疗者纳入联合用药组(n=40),2组均以3周为1个治疗周期,共治疗2个周期。比较2组患者近期疗效,用药前后实验室指标、生活质量评分,不良反应及1年存活率。结果联合用药组客观缓解率为85.00%,高于GP化疗组的52.50%(χ^(2)=9.833,P=0.002)。用药2个周期后,2组血清癌胚抗原、糖类抗原125水平低于用药前,凝血酶时间、活化部分凝血活酶时间短于用药前,凝血酶原时间长于用药前,血浆纤维蛋白原、D-二聚体水平高于用药前,且联合用药组各指标优于对照组(P<0.05或P<0.01);2组生理功能、躯体功能、精神状态、社会关系评分高于用药前,且联合用药组高于GP化疗组(P<0.01)。联合用药组与GP化疗组不良反应总发生率分别为22.50%、15.00%,组间比较差异无统计学意义(χ^(2)=0.738,P=0.390)。联合用药组1年存活率为65.00%,高于GP化疗组的42.50%(χ^(2)=4.073,P=0.044)。结论晚期NSCLC治疗中采用重组人血管内皮抑制素注射液联合化疗药物的可行性较高,可有效降低肿瘤标志物水平,延缓病情进展,提高患者生活质量及1年存活率,且具有一定安全性。

清肺化痰汤治疗痰热郁肺证老年晚期非小细胞肺癌患者的临床疗效及对其生活质量、血清癌胚抗原、神经元特异性烯醇化酶、细胞角质素片段抗原水平的影响

目的探讨清肺化痰汤治疗痰热郁肺证老年晚期非小细胞肺癌患者的临床疗效及对其生活质量、血清癌胚抗原(Carcinoembryonic antigen,CEA)、神经元特异性烯醇化酶(Neuron specific enolase,NSE)、细胞角质素片段抗原(Cytokeratin 19 fragment antigen21-1,CYRAF21-1)水平的影响。方法选取2019年7月—2020年10月期间在东南大学医学院附属南京同仁医院接受治疗的非小细胞肺癌患者80例,采用随机数字表法分为对照组和观察组,每组各40例。对照组采用DP化疗方案治疗,观察组在对照组基础上联合清肺化痰汤治疗,每个疗程为21 d,连续治疗4个疗程。观察比较两组患者临床疗效、不良反应情况,治疗前后痰热郁肺证证候积分(咳嗽,咳痰、咯痰黄稠,气喘或气急,喉中痰鸣,发热,口渴)、血清肿瘤标记物(CEA、NSE、CYRAF21-1)、生命质量量表(QOL-38)评分改善情况。结果治疗后观察组总缓解率62.5%(25/40)、临床获益率85.0%(34/40)均明显高于对照组总缓解率40.0%(16/40)、临床获益率65.0%(26/40),差异有统计学意义(P<0.05)。治疗后两组患者咳嗽、咳痰、咯痰黄稠、气喘或气急、喉中痰鸣、发热、口渴评分均较治疗前降低,差异有统计学意义(P<0.01);且观察组痰热郁肺证证候积分明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血清CEA、NSE及CYRAF21-1水平均较治疗前明显降低,差异有统计学意义(P<0.01);且观察组血清CEA、NSE及CYRAF21-1水平均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者身体状况、情绪状况、功能状况、肺癌相关症状、社会/家庭状况评分均较治疗前明显降低,总体健康状况评分较治疗前明显升高,差异有统计学意义(P<0.01);且观察组QOL-38评分改善情况明显优于对照组,差异有统计学意义(P<0.05)。治疗期间,观察组不良反应发生率明显低于对照组,差异有统计学意义(P<0.05)。结论清肺化痰汤治疗痰热郁肺证老年晚期非小细胞肺癌疗效显著,能够有效降低血清CEA、NSE及CYRAF21-1水平,缓解临床症状,减轻化疗药物不良反应,提高患者生活质量。

艾迪注射液辅助化疗治疗老年晚期非小细胞肺癌患者的疗效分析

目的探讨对老年晚期非小细胞肺癌患者给予艾迪注射液辅助化疗治疗的临床效果。方法62例老年晚期非小细胞肺癌患者,依据投掷硬币法分为参照组和研究组,各31例。参照组患者采用吉西他滨和顺铂(GP)化疗治疗,研究组患者在参照组基础上采用艾迪注射液治疗。比较两组患者治疗效果、免疫功能[CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)CD25^(+)调节性T细胞(Treg)]以及生存质量评分(生理层面、心理层面、社会层面、环境层面评分)。结果研究组客观有效率45.16%、疾病控制率87.10%均高于参照组的19.35%、54.84%(P<0.05)。治疗后,研究组CD3^(+)(55.65±7.86)%、CD4^(+)(36.29±5.49)%高于参照组的(50.16±8.42)%、(30.49±4.19)%,CD8^(+)(22.59±4.89)%、CD4^(+)CD25^(+)Treg(4.36±1.08)%低于参照组的(26.15±4.36)%、(8.15±1.39)%(P<0.05)。治疗后,研究组生理层面、心理层面、社会层面、环境层面评分分别为(70.33±3.12)、(71.44±3.25)、(71.64±5.22)、(71.87±4.25)分,高于参照组的(60.36±2.25)、(60.64±5.15)、(60.65±4.22)、(60.64±5.25)分(P<0.05)。结论临床对老年晚期非小细胞肺癌患者给予艾迪注射液辅助化疗治疗,可提升治疗效果以及生存质量,改善免疫功能,临床可推广应用。

Radiofrequency deep hyperthermia combined with chemotherapy in the treatment of advanced non-small cell lung cancer

Background:In the era of precision medicine,chemotherapy is still considered the cornerstone of treatment for lung cancer patients without gene mutations.How to reduce the toxicity and increase the efficiency of chemotherapy is worth exploring.This study aimed to investigate the curative effects and safety of hyperthermia combined with chemotherapy(HCT)for advanced patients with non-small cell lung cancer(NSCLC),especially those with malignant pleural effusion.Methods:We retrospectively evaluated medical records of 93 patients with advanced NSCLC(stage IIIB-IV)from March 2011 to January 2014.The patients were divided into HCT and chemotherapy(CT)groups.The HCT group was treated with gemcitabine and cisplatin(GP)regimen combined with regional radiofrequency deep hyperthermia,while the CT group was treated with GP regimen only.Those with malignant pleural effusion extra underwent thoracentesis and intrapleural injection chemotherapy combined with hyperthermic or not.Clinical treatment results and adverse reactions were compared and analyzed after treatment.SPSS 19.0 software(SPSS Inc.,USA)was used for statistical data processing.P values less than 0.05 were accepted to be statistically significant.Results:Among the 93 patients,HCT group included 48 patients(16 patients with malignant pleural effusion),CT group included 45 patients(10 patients with malignant pleural effusion).There was no significant difference between the two groups in patient characteristics.The overall response rate(ORR)of pleural effusions was much better in HCT group than that in CT group(81.2%vs.40.0%,P=0.046).The patients in HCT group had lower incidence rate of weakness(12.5%us.46.7%,χ^2=13.16,P<0.001)and gastrointestinal(25.0%vs.77.8%,χ^2=25.88,P<0.001)adverse reactions than that in CT group.The objective tumor response and survival showed no significant differences.Conclusions:Hyperthermia combined with chemotherapy might lead to the development of better therapeutic strategy for advanced NSCLC with malignant pleural effusion patients.Also,it could greatly reduce the chemotherapy toxic effects in the incidence of weakness and gastrointestinal adverse reactions in advanced NSCLC patients.

贝伐珠单抗联合TP化疗方案治疗晚期NSCLC的疗效

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。