Effect of afatinib combined with pemetrexed and carboplatin chemotherapy in patients with gefitinib resistant lung adenocarcinoma
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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