摘要
目的 探讨深部热疗联合重组人血管内皮抑制素注射液及培美曲塞联合顺铂(AP方案)治疗晚期非小细胞肺癌(NSCLC)的近期疗效.方法 回顾性分析2016年1月至2022年1月河北省第七人民医院收治的120例晚期NSCLC患者的相关资料,按照治疗方法不同将患者分为研究组(n=59)和对照组(n=61).研究组患者采用深部热疗联合重组人血管内皮抑制素注射液及AP方案治疗,对照组患者采用重组人血管内皮抑制素注射液及AP方案.观察两组患者的近期疗效[客观反应率(ORR)、疾病控制率(DCR)],治疗前、治疗后3个月的血清肿瘤标志物[神经元特异性烯醇化酶(NSE)、糖类抗原125(CA125)、细胞角质素片段抗原(Cyfra21-1)及癌胚抗原(CEA)]水平、生活质量评分(KPS)评分]、血常规指标[红细胞计数(RBC)、白细胞计数(WBC)、血小板计数(PLT)]以及不良反应发生情况.结果 研究组O RR、DCR分别为15.25％、57.63％,均高于对照组(3.28％、36.07％),差异均有统计学意义(P＜0.05).治疗3个月后,两组NSE、CA125、Cyfra21-1、CEA水平均低于治疗前,且研究组治疗后NSE、CA125、Cyfra21-1、CEA水平分别为(15.23±5.06)ng/mL、(50.16±5.12)U/mL、(6.52±2.03)ng/mL、(30.17±4.17)ng/mL,均低于对照组[(20.16±5.04)ng/mL、(80.24±5.22)U/mL、(10.25±3.09)ng/mL、(60.22±4.17)ng/mL],差异均有统计学意义(P＜0.05).研究组KPS改善率为77.97％,高于对照组(57.38％),差异有统计学意义(P＜0.05).治疗3个月后,两组 RBC、WBC、PLT 值均较治疗前降低,研究组 RBC、WBC、PLT 值分别为(3.61±0.12)× 1012、(3.98±1.07)× 109、(210.23±30.16)×109,均高于对照组[(3.50±0.11)× 1012、(3.12±1.03)× 109、(198.24±20.17)× 109],差异均有统计学意义(P＜0.05).研究组0～Ⅳ级胃肠道不适、肝损伤、肾损伤、贫血不良反应发生率与对照组比较,差异均有统计学意义(P＜0.05),研究组各种不良反应的严重程度低于对照组.结论 深部热疗联合重组人血管内皮抑制素注射液及AP方案可有效提高晚期NSCLC患者的近期疗效,降低肿瘤标志物水平,改善生活质量和血常规,减少不良反应发生,值得临床推广和应用.
Abstract
Objective To investigate the short-term efficacy of deep hyperthermia combined with recombinant human endostatin injec-tion and pemetrexed combined with cisplatin(AP regimen)in the treatment of advanced non-small cell lung cancer(NSCLC).Methods Ret-rospective analysis was used on the relevant data of 120 patients with advanced NSCLC admitted to the Seventh People's Hospital of Hebei Province from January 2016 to January 2021.They were divided into the study group(n=59)and the control group(n=61)according to different treat-ment methods.The patients in the study group were treated with deep hyperthermia combined with recombinant human endostatin injection and AP regimen,while the patients in the control group were treated with recombinant human endostatin injection and AP regimen.The short-term effica-cy[objective response rate(ORR),disease control rate(DCR)],serum tumor markers[neuron specific enolase(NSE),carbohydrate antigen(CA125),cytokinin fragment antigen(Cyfra21-1),and carcinoembryonic antigen(CEA)]levels,quality of life score[karnofsky performance status(KPS)score],blood routine indicators[red blood cells count(RBC),white blood cells count(WBC),platelets count(PLT)]before and 3 months after treatment,and adverse reactions of two groups of patients were observed.Results The ORR and DCR of the study group were 15.25％,57.63％,which were higher than those of the control group(3.28％,36.07％),the differences were statistically significant(P＜0.05).After 3 months of treatment,the levels of NSE,CA125,Cyfra21-1,and CEA in two groups were lower than those before treatment,and the levels of NSE,CA125,Cyfra21-1,and CEA in the study group were(15.23±5.06)ng/mL,(50.16±5.12)U/mL,(6.52±2.03)ng/mL,(30.17±4.17)ng/mL,respectively,which were lower than those in the control group[(20.16±5.04)ng/mL,(80.24±5.22)U/mL,(10.25±3.09)ng/mL,(60.22±4.17)ng/mL],the differences were statistically significant(P＜0.05).The improvement rate of KPS in the study group was 77.97％,which was higher than that in the control group(57.38％),the difference was statistically significant(P＜0.05).After 3 months of treatment,the RBC,WBC,and PLT values in two groups were lower than those before treatment,and the RBC,WBC,and PLT values in the study group were(3.61±0.12)×1012,(3.98±1.07)×109,(210.23±30.16)×109,respectively,which were higher than the control group[(3.50±0.11)]×1012,(3.12±1.03)× 109,(198.24±20.17)×l09],the differences were statistically significant(P＜0.05).The incidence of gastrointestinal discomfort,liver injury,kidney injury and anemia in the study group and the control group were com-pared,and the differences were statistically significant(P＜0.05),the severity of adverse reactions in the study group was lower than that in the control group.Conclusion Deep hyperthermia combined with recombinant human endostatin injection and AP can effectively improve the short-term efficacy of patients with advanced NSCLC,reduce the level of tumor markers,improve the quality of life and blood routine,and reduce the occurrence of adverse reactions.It is worthy of clinical promotion and application.
维普
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