摘要
目的 探究程序性死亡受体1(PD-1)抑制剂联合安罗替尼治疗二线化疗失败的老年晚期非小细胞肺癌(NSCLC)的临床疗效。方法 选取2019年1月—2021年4月泰州市第二人民医院收治的106例二线化疗失败的老年晚期NSCLC患者作为研究对象,按照随机数字表法分为单药组和联合组,各53例。单药组采用安罗替尼治疗,联合组采用PD-1抑制剂联合安罗替尼治疗。比较两组的疾病控制率、毒副反应发生情况、生存率、肿瘤标志物[细胞角蛋白19片段抗原21-1(CYFRA21-1)、癌胚抗原(CEA)、糖类抗原125(CA125)]、血管新生指标[血管内皮生长因子(VEGF)-A、VEGF受体2(VEGFR2)]、血清驱动蛋白超家族蛋白(KIF)C1、N-钙黏蛋白、生活质量核心量表(QLQ-C30)评分。结果 联合组疾病控制率高于单药组(P<0.05);治疗2个周期后,联合组血清CYFRA21-1、CA125、CEA、VEGF-A、VEGFR2、KIFC1及N-钙黏蛋白水平均低于单药组(P<0.05),QLQ-C30评分低于单药组(P<0.05);两组各毒副反应总发生率比较,差异均无统计学意义(P>0.05);Kaplan-Meier生存分析显示,联合组累积生存率高于单药组(P<0.05)。结论 PD-1抑制剂联合安罗替尼治疗二线化疗失败的老年晚期NSCLC效果显著,可有效调节血清KIFC1、N-钙黏蛋白表达,抑制VEGF-A、VEGFR2水平,降低肿瘤标志物水平,提高生活质量,延长生存时间,安全性高。
Objective To explore the clinical efficacy of a programmed death receptor 1(PD-1)inhibitor in combination with amilorotinib in the treatment of elderly advanced non-small cell lung cancer(NSCLC)that has failed second-line chemotherapy.Methods A total of 106 elderly advanced NSCLC patients who failed second-line chemotherapy admitted to Taizhou Second People's Hospital from January 2019 to April 2021 were selected as the study subjects,they were divided into the single-agent group and the combination group according to the method of randomized numerical table,each had 53 cases.The single-agent group was treated with Anlotinib,and the combination group was treated with PD-1 inhibitor combined with Anlotinib.The indicators of disease control rate,incidence of toxic side reactions,survival rate,tumor markers[cytokeratin 19 fragment antigen 21-1(CYFRA21-1),carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125)],angiogenesis indicators[vascular endothelial growth factor(VEGF-A),VEGF receptor 2(VEGFR2)],serum kinesin superfamily protein(KIF)C1,N-cadherin and the Quality of Life Core Scale(QLQ-C30)scores were compared.Results The disease control rate in the combination group was higher than that in the monotherapy group(P<0.05);After two cycles of treatment,the serum levels of CYFRA21-1,CA125,CEA,VEGF-A,VEGFR2,KIFC1,and N-cadherin in the combination group were lower than those in the monotherapy group(P<0.05),and the QLQ-C30 score was lower than that in the monotherapy group(P<0.05);There was no statistically significant difference in the incidence of toxic side effects between the two groups(P>0.05);Kaplan Meier survival analysis showed that the combined group had a higher cumulative survival rate than the monotherapy group(P<0.05).Conclusion The PD-1 inhibitor combined with Anlotinib is effective in the treatment of second-line chemotherapy failure of elderly advanced NSCLC.It can effectively regulate serum KIFC1,N-calcium fucoidan expression,inhibit the level of VEGF-A,VEGFR2,reduce the level of tumor markers,i
作者
张志胜
何学军
张晶
纪晓燕
朱翔
包赟
Zhang Zhisheng;He Xuejun;Zhang Jing;Ji Xiaoyan;Zhu Xiang;Bao Yun(Taizhou Second People's Hospital,Taizhou 225511)
出处
《国际老年医学杂志》
2024年第2期187-192,共6页
International Journal of Geriatrics
基金
江苏省老年健康科研项目(LKM202285)
泰州市科技支撑计划社会发展(指导性)项目。
关键词
程序性死亡受体1抑制剂
二线化疗失败
安罗替尼
非小细胞肺癌
生存期
Programmed death receptor 1 inhibitor
Second-line chemotherapy failure
Anlotinib
Non-small cell lung cancer
Survival
