摘要
目的探讨贝伐珠单抗联合TP(紫杉醇+顺铂)化疗方案治疗晚期非小细胞肺癌(NSCLC)的疗效及对预后的影响。方法选取晚期NSCLC患者78例,随机分为A组(39例,予以TP化疗方案)和B组(39例,予以TP化疗方案+贝伐珠单抗)。比较2组的客观缓解率(ORR)、疾病控制率(DCR)和血清肿瘤标志物[血管内皮生长因子(VEGF)、细胞角蛋白19片段(CYFRA21-1)、癌胚抗原(CEA)]水平。记录治疗期间肝肾功能损害、白细胞减少、中性粒细胞减少、血小板减少、胃肠道反应等不良反应发生情况。自实施治疗日始对患者进行随访,统计2组患者的5年生存率、无进展生存期(PFS)和总生存期(OS)。结果B组ORR、DCR分别为58.97%、89.74%,分别高于A组的35.90%、71.79%(P<0.05)。治疗后2组血清VEGF、CYFRA21-1、CEA水平均降低,且B组低于A组(P<0.05)。2组肝、肾功能损害,白细胞减少,中性粒细胞减少,血小板减少,胃肠道反应发生率均无明显差异(P>0.05)。B组5年生存率为20.51%,与A组(12.82%)相比无明显差异(P>0.05)。Kaplan-Meier生存曲线显示,B组的中位PFS长于A组(8.9 vs 7.2个月)(P<0.05);B组的中位OS长于A组(25.6 vs 17.9个月)(P<0.05)。结论相比于TP化疗方案治疗晚期NSCLC,联合贝伐珠单抗可提高ORR和DCR,延长PFS和OS,且可降低VEGF、CYFRA21-1、CEA肿瘤标志物水平。
Objective To investigate the efficacy of bevacizumab combined with TP chemotherapy(paclitaxel+cisplatin)in the treatment of advanced non-small cell lung cancer(NSCLC)and its influence on prognosis.Methods 78 patients with advanced NSCLC were randomly divided into group A(39 cases,receiving TP chemotherapy)and group B(39 cases,receiving TP chemotherapy+bevacizumab).The objective response rate(ORR),disease control rate(DCR)and serum tumor markers levels(vascular endothelial growth factor,VEGF;cytokeratin 19 fragment,CYFRA21-1;carcinoembryonic antigen,CEA)were compared between the 2 groups.Adverse reactions such as liver and renal dysfunction,leukopenia,neutropenia,thrombocytopenia and gastrointestinal reactions were recorded during treatment.Patients were followed up from the start of treatment,and 5-year survival,progression-free survival(PFS)and overall survival(OS)of the 2 groups were counted.Results ORR and DCR of group B were 58.97%and 89.74%,respectively,higher than 35.90%and 71.79%of group A(P<0.05).After treatment,serum levels of VEGF,CYFRA21-1 and CEA in the 2 groups decreased,and group B was lower than group A(P<0.05).There were no significant differences in the incidence of liver and renal dysfunction,leukopenia,neutropenia,thrombocytopenia and gastrointestinal reactions between the 2 groups(P<0.05).The 5-year survival rate of group B was 20.51%,which was not significantly different from group A(12.82%)(P>0.05).The median PFS were longer in group B than in group A(8.9 vs 7.2 months)(P<0.05);the median OS in group B was longer than that in group A(25.6 vs 17.9 months)(P<0.05).Conclusion Compared with TP chemotherapy in the treatment of advanced NSCLC,combined bevacizumab can increase ORR and DCR,prolong PFS and OS,and reduce the levels of VEGF,CYFRA21-1 and CEA tumor markers.
作者
梁博
闻朋浩
朱敏敏
任中海
LIANG Bo;WEN Penghao;ZHU Minmin(Nanshi Hospital of Nanyang,Nanyang,473000)
出处
《实用癌症杂志》
2024年第8期1293-1296,共4页
The Practical Journal of Cancer
