目的 探讨升陷汤加味联合安罗替尼对老年晚期肺鳞癌患者的生存情况及预后的影响。方法 选取2019年3月—2020年11月医院收治的老年晚期肺鳞癌患者148例，随机分为升陷组和对照组，各74例。对照组给予安罗替尼，升陷组在对照组基础上给予升陷汤加味治疗。两组均连续治疗至病情进展或不能耐受药物不良反应。比较两组患者近期临床疗效、治疗前及治疗2个疗程后血清肿瘤标志物[癌胚抗原(carcinoembryonlic antigen，CEA)、细胞角蛋白19片段抗原 21-1(cytokeratin 19 fragment antigen21-1，CY21-1)]、预后生存质量[美国东部肿瘤协作组(Eastern Cooperative Oncology Group，ECOG)评分、生活质量(quality of life，QOL)评分法]、治疗期间不良反应发生情况，绘制两组随访的生存曲线[无进展生存期(progression free survival，PFS)、总生存时间(overall survival，OS)]。结果 (1)与对照组比较，升陷组患者客观缓解率(objective remission rate，ORR)、疾病控制率(disease control rate，DCR)均显著升高(P＜0。05)。(2)肿瘤标志物:治疗2个疗程后，两组血清CEA、CY21-1水平均低于治疗前，且升陷组均低于对照组(均P＜0。05)。(3)预后生存质量:两组治疗后ECOG评分低于治疗前，QOL评分高于治疗前，且升陷组优于对照组(均P＜0。05)。(4)不良反应:治疗期间，两组不良反应包括疲乏、高血压、消化道反应、高脂血症、出血等，多为Ⅰ～Ⅱ级，总不良反应发生率比较，差异均无统计学意义(P＞0。05)。(5)生存情况:升陷组患者PFS中位数为11个月(95％CI:9。76～12。24)，OS中位数13个月(95％CI:12。03～13。97);对照组患者PFS中位数为7个月(95％CI:6。298～7。702)，OS中位数为10个月(95％CI:9。16～10。84)。升陷组患者的PFS、OS 均高于对照组(PFS:x2=5。316，P=0。021;OS:x2=4。921，P=0。027)，差异均有统计学意义。结论 老年晚期肺鳞癌患者应用升陷汤加味联合安罗替尼治疗可提高疾病控制率，下调血清肿瘤标志物，改善预后，延长生存周期，且不增加不良反应发生率，具有一定临床应用价值。
A Prospective Study on Survival Rate and Prognosis of Senile Patients with Advanced Lung Squamous Cell Carcinoma Treated with Modified Shengshen Decoction(升陷汤加味)
Objective To explore the effect of Modified Shengshen Decoction(升陷汤加味)combined with arotinib on the sur-vival and prognosis of elderly patients with advanced lung squamous cell carcinoma.Methods A total of 148 elderly patients with advanced lung squamous cell carcinoma admitted to the hospital from March 2019 to November 2020 were randomly divided into Shengshen Decoction group and control group,with 74 cases in each.The control group was treated with arotinib,and the Sheng-shen Decoction group was treated with Modified Shengshen Decoction on the basis of the control group.Both groups were treated continuously until the disease progressed or could not tolerate the side effects of drugs.The recent clinical efficacy,serum tumor markers[carcinoembryonic antigen(CEA),cytokeratin 19 fragment antigen 21-1(CY21-1)],prognosis quality of life[Eastern Cooperative Oncology Group(ECOG)score,quality of life(QOL)score method]and adverse reactions during treatment of the two groups were compared,and it drew the survival curves[progression-free survival(PFS),total survival time(OS)]of the two groups of follow-up.Results(1)Compared with those of the control group,the objective remission rate(ORR)and disease con-trol rate(DCR)of the patients in the Shengshen Decoction group were significantly higher(P＜0.05).(2)Tumor markers:After two courses of treatment,the serum CEA and CY21-1 levels in the two groups were lower than those before treatment,and those in the Shengshen Decoction group were lower than those in the control group(all P＜0.05).(3)Prognosis and quality of life:The ECOG score after treatment in the two groups was lower than that before treatment,the QOL score was higher than that before treatment,and the Shengshen Decoction group was better than the control group(both P＜0.05).(4)Adverse reactions.During the treatment period,the adverse reactions in the two groups included fatigue,hypertension,gastrointestinal reactions,hyperlipi-demia,bleeding,etc.,most of which were grade Ⅰ to Ⅱ.There was no statistically significant difference in the incidence of the two total adverse reactions(P＞0.05).(5)Survival:The median progression free survival(PFS)of patients with depression was 11 months(95％CI;9.76～12.24),and the median overall survival(OS)was 13 months(95％CI;12.03～13.97).The median PFS of patients in the control group was 7 months(95％CI;6.298～7.702),and the median OS was 10 months(95％CI;9.16～10.84).The PFS and OS of patients in the depression group were higher than those in the control group(PFS:x2=5.316,P=0.021;OS:x2=4.921,P=0.027),and the difference was statistically significant.Conclusions The treatment of elderly patients with advanced squamous cell carcinoma of the lung with Shengshen Decoction and Androtinib can improve the disease control rate,reduce the serum tumor markers,improve the prognosis,prolong the life cycle,and do not increase the incidence of adverse reactions.It has certain clinical application value.
advanced squamous cell carcinoma of lungShengshen Decoction(升陷汤)old ageandrotinibsurvival analy-sisprognosis
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