Objective To investigate the clinical effect of afatinib combined with pemetrexed and carboplatin chemotherapy in patients with gefitinib resistant lung adenocarcinoma.Methods A total of 84 patients with gefitinib-resistant lung adenocarcinoma admitted to Shangqiu First People's Hospital from January 2021 to December 2022 were selected and were divided into an observation group(42 cases)and a control group(42 cases)according to the random number table method.In the control group,there were 24 males and 18 females,the age was 37-68(52.58±2.21)years old,the body mass index(BMI)was 18-27(23.11±1.17)kg/m2,the lesions were at left upper in 18 cases,left lower in 16 cases,right upper in 5 cases,and right lower in 3 cases,and the clinical stage was stage Ⅲ in 20 cases and stage Ⅳ in 22 cases.In the observation group,there were 21 males and 21 females,the age was 37-68(52.67±2.24)years old,the BMI was 18-27(23.06±1.14)kg/m2,the lesions were at left upper in 17 cases,left lower in 14 cases,right upper in 5 cases,and right lower in 6 cases,and the clinical stage was stage Ⅲ in 18 cases and stage Ⅳ in 24 cases.The control group received pemetrexed and carboplatin chemotherapy,and the observation group received afatinib treatment on the basis of the control group.Both groups were treated for 2 courses.The therapeutic effect,tumor markers[carbohydrate antigen 199(CA199),carcinoembryonic antigen(CEA),and neuron-specific enolase(NSE)],immune function(T lymphocyte subsets CD3+,CD4+,and CD8+),and adverse reactions were compared between the two groups.Independent sample t test and x2 test were used.Results The total effective rate of the observation group[76.19％(32/42)]was higher than that of the control group[52.38％(22/42)](P＜0.05).After treatment,the levels of CA199[(44.39±3.88)μg/L],NSE[(13.45±1.22)μg/L],and CEA[(6.17±0.57)μg/L]in the observation group were lower than those in the control group[(61.02±5.24)μg/L,(18.69±1.74)μg/L,and(9.26±0.81)μg/L](all P＜0.05).After treatment,the levels of CD3+[(65.39±5.22)％]and CD4+[(36.15±2.71)％]in the observation group were higher than those in the control group[(57.69±4.38)％and(31.58±2.64)％],but the level of CD8+[(27.16±1.53)％]was lower than that in the control group[(30.87±2.07)％](all P＜0.05).During treatment,there was no statistically significant difference in the total incidence of adverse reactions between the observation group[26.19％(11/42)]and the control group[19.05％(8/42)](P＞0.05).Conclusion Afatinib combined with pemetrexel and carboplatin chemotherapy has a significant therapeutic effect in patients with gefitinib-resistant lung adenocarcinoma,which can reduce the levels of tumor markers and the damage on immune function,and has high safety.
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