摘要
目的探讨华蟾素胶囊联合吉非替尼对晚期表皮生长因子受体(EGFR)突变的非小细胞肺癌患者临床疗效及血清miR-221的影响。方法选取2016年6月—2018年6月就诊于新乡医学院第一附属医院肿瘤科的晚期EGFR突变的NSCLC患者75例,随机分为吉非替尼治疗组(对照组,37例)和华蟾素胶囊+吉非替尼治疗组(治疗组,38例),观察两组患者临床疗效、不良反应、无疾病生存期(PFS)及血清miR-221表达情况。结果对照组部分缓解(PR)为62.1%,疾病稳定(SD)为21.6%,疾病进展(PD)为8.1%,客观有效率(ORR)为62.1%,疾病控制率(DCR)为83.7%;治疗组PR为65.8%,SD为26.3%,PD为5.2%,ORR为65.8%,DCR为92.1%,两组相比,ORR无明显差异,但DCR差异显著(P<0.01);对照组中位PFS为10.1个月,治疗组中位PFS为12.6个月,两组相比,差异显著(P<0.01);两组患者皮疹、腹泻、肝功能损伤等不良反应发生率方面比较,无明显差异(P>0.05);对照组疾病进展后miR-221相对表达水平为8.05±0.06,与治疗前3.01±0.02相比,显著升高(P<0.01);治疗组患者疾病进展后miR-221相对表达水平为6.32±0.03,与对照组相比8.05±0.06,显著降低(P<0.05)。结论华蟾素胶囊联合吉非替尼可提高EGFR突变的晚期非小细胞肺癌临床疗效,延长PFS,下调血清miR-221表达水平,具有延缓吉非替尼耐药的作用。
Objective To investigate the effect of cinobufagin capsule combined with gefitinib on the clinical efficacy and serum miR-221 of patients with advanced epidermal growth factor receptor(EGFR)mutation in non-small cell lung cancer.Methods 75 NSCLC patients with advanced EGFR mutation treated in the oncology department of the First Affiliated Hospital of Xinxiang Medical College from June 2016 to June 2018 were randomly divided into gefitinib treatment group(control group,37 cases)and Cinobufacin capsule+gefitinib treatment group(treatment group,38 cases).The clinical efficacy,adverse reactions and disease-free survival(PFS),the expression of serum miR-221of the two groups were observed.Results In the control group,the partial remission(PR)was 62.1%,the disease stability(SD)was 21.6%,the disease progression(PD)was 8.1%,the objective effective rate(ORR)was 62.1%,and the disease control rate(DCR)was 83.7%;In the treatment group,PR was 65.8%,SD was 26.3%,PD was 5.2%,ORR was 65.8% and DCR was 92.1%.There was no significant difference in ORR between the two groups,but there was significant difference in DCR(P<0.01);The median PFS in the control group was 10.1 months and that in the treatment group was 12.6 months.There was significant difference between the two groups(P<0.01);There was no significant difference in the incidence of skin rash,diarrhea and liver function injury between the two groups(P>0.05);The relative expression level of miR-221 in the control group was 8.05±0.06,which was significantly higher than that before treatment(3.01±0.02)(P<0.01);The relative expression level of miR-221 in the treatment group was 6.32±0.03,which was significantly lower than that in the control group(8.05±0.06)(P<0.05).Conclusion Cinobufagin capsule combined with gefitinib can improve the clinical efficacy of EGFR mutant advanced non-small cell lung cancer,prolong PFS,down regulate the expression level of serum miR-221,and delay the drug resistance of gefitinib.
作者
王颖
唐晓男
王会宜
崔艳慧
曹飞
康小红
WANG Ying;TANG Xiaonan;WANG Huiyi;CUI Yanhui;CAO Fei;KANG Xiaohong(Department of Oncology,The First Affiliated Hospital of Xinxiang Medical College,Henan Xinxiang 453100,China;Cancer Research Center of Pingdingshan First People's Hospital,Henan Pingdingshan 467000,China)
出处
《陕西中医药大学学报》
2021年第6期84-88,共5页
Journal of Shaanxi University of Chinese Medicine
基金
国家自然科学基金项目(82074268,81503414,81874392,82074231)
河南省医学科技攻关项目(SB201903014,LHGJ20191263)。
