Gefitinib combined with intensity-modulated radiotherapy in the treatment of elderly patients with advanced non-small cell lung cancer and its effect on the expression of serum miR-224 and miR-195
Objective To investigate the effect of gefitinib combined with intensity-modulated radiotherapy on elderly patients with advanced non-small cell lung cancer(NSCLC)and its effect on the expression of serum miR-224 and miR-195. Methods A total of 92 elderly patients with advanced NSCLC were admitted to Henan Cancer Hospital (Zhengzhou University Affiliated Cancer Hospital) from February 2018 to February 2020. These patients were randomly divided into a study group and a control group ,with 46 cases in each group. The control group received intensity-modulated radiation therapy ,while the study group received a combination of gefitinib and intensity-modulated radiation therapy. The efficacy,adverse reactions,1-year,2-year,and 3-year survival rates after treatment,as well as serum tumor marker indicators(cytokeratin 19 fragment antigen 21-1 (CYFRA21-1),squamous cell carcinoma antigen (SCC),carcinoembryonic antigen (CEA)),immune function indicators(CD3+,CD4+,CD8+,CD4+/CD8+),miR-224,and miR-195 levels were compared between the study group and the control group. Results After treatment,the disease control rate(DCR)in the study group was higher than that in the control group(x2=5.392,P<0.05). After treatment, the serum levels of CYFRA21-1,SCC,and CEA decreased in both the study group and control group,with the gefitinib group showing lower levels than the control group(t=9.364,9.391,9.822,P<0.05). After treatment,the serum levels of CD3+,CD4+,and CD4+/CD8+increased in the study group,surpassing those in the control group(t=4.667,4.913,2.923,P<0.05). Conversely,the serum miR-224 levels decreased in both the study group and the control group after treatment,with the study group exhibiting lower levels than the control group(t=4.378,P<0.05). However,the miR-195 level increased in the study group after treatment,and it was higher than that in the control group(t=2.787,P<0.05). Lastly,the study group had higher 2-year and 3-year survival rates after treatment compared to the control group (x2=4.142,4.022,P<0.05). Conclusion Combining gefitinib with intensity-modulated radiotherapy has shown potential in improving the treatment outcomes for elderly patients with advanced NSCLC. This approach can enhance the therapeutic effect ,regulate the expression of miR-224 and miR-195,and ultimately extend the survival time of patients.
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