厄洛替尼联合贝伐株单抗治疗老年晚期非小细胞肺癌患者的临床观察

Clinical observation of erlotinib combined with bevacizumab in treatment of elderly patients with advanced non-small cell lung cancer

中文关键词: 老年  非小细胞肺癌  贝伐株单抗  厄洛替尼  免疫功能  基因突变  炎性因子  肿瘤标志物

英文关键词: elderly  non-small cell lung cancer  bevacizumab  erlotinib  immune function  gene mutation  inflammato-ry factor  tumor marker

中文摘要:

      目的 观察厄洛替尼联合贝伐株单抗对老年晚期非小细胞肺癌(NSCLC)患者血清肿瘤标志物、免疫功能等影响,为治疗该病提供方法.方法 选取2019年5月-2022年5月上海嘉会国际医院经基因检测确定无T790M突变的老年NSCLC患者104例,根据治疗方案不同分成2组:观察组(n=52)和对照组(n=52).对照组患者口服厄洛替尼,观察组患者在对照组治疗的基础上静脉滴注贝伐株单抗.观察并比较2组患者临床疗效、不良反应;检测并比较2组治疗前后血清神经元特异性烯醇化酶(NSE)、癌胚抗原(CEA)、细胞角质素片段抗原21-1(CYFRA21-1)、糖类抗原125(CA-125)、白细胞介素-6(IIL-6)、IL-2、IL-5、肿瘤坏死因子-α(TNF-α)、IL-4、干扰素-γ(INF-γ)和NK 细胞、CD8+、CD4+、CD3+、CD4+/CD8+检测值.结果 治疗后,观察组RR、PFS及OS值均高(或长)于对照组,差异有统计学意义(P＜0.05);观察组血清NSE、CEA、CYERA21-1及CA125值较治疗前水平下降,且下降幅度大于对照组(P＜0.05);观察组血清IL-6、IL-2、TNF-α、及INF-γ水平较治疗前上升(P＜0.05),且上升幅度大于对照组(P＜0.05);观察组血清IL-5、IL-4水平较治疗前下降(P＜0.05),且下降幅度大于对照组(P＜0.05);观察组血清NK、CD3+、CD4+及CD4+/CD8+值较治疗前上升(P＜0.05),且上升幅度大于对照组(P＜0.05);观察组治疗后CD8+值较治疗前下降(P＜0.05),且下降幅度大于对照组(P＜0.05).结论 厄洛替尼联合贝伐株单抗可明显改善老年晚期NSCLC患者血清肿瘤标志物水平与机体免疫功能,有一定的临床应用价值.

英文摘要:

      Objective To observe the effects of erlotinib combined with bevacizumab on serum tumor markers and im-mune function in elderly patients with advanced non-small cell lung cancer(NSCLC),and provide a method for the treatment of this disease.Methods 104 elderly NSCLC patients without T790M mutation confirmed by genetic testing in Shanghai Ji-ahui International Hospital from May 2019 to May 2022 were selected and divided into two groups according to different treat-ment regimens:observation group(n=52)and control group(n=52).The control group received oral erlotinib,while the observation group received intravenous infusion of bevacizumab on the basis of treatment in the control group.The clinical effi-cacy and adverse reactions of the two groups were observed and compared.The levels of serum neuron-specific enolase(NSE),carcinoembryonic antigen(CEA),keratin-fragment antigen 21-1(CYFRA21-1),carbohydrate antigen 125(CA-125),interleukin-6(IIL-6),IL-2,IL-5,tumor necrosis factor-α(TNF-α),IL-4,interferon-γ(INF-γ),NK cell,CD8+,CD4+,CD3+,CD4+/CD8+of the two groups were detected and compared before and after treatment.Results After treat-ment,the response rate(RR),progression-free survival(PFS)and overall survival(OS)of the observation group were higher or longer than those of the control group,with statistical differences(P＜0.05);the levels of serum NSE,CEA,CYERA21-1 and CA125 of the observation group decreased compared with those before treatment,and the decrease was greater than that of the control group(P＜0.05);the levels of serum IL-6,IL-2,TNF-α and IFN-γ of the observation group increased com-pared with those before treatment(P＜0.05),and the increase was greater than that of the control group(P＜0.05);the lev-els of serum IL-5 and IL-4 of the observation group decreased compared with those before treatment(P＜0.05),and the de-crease was greater than that of the control group(P＜0.05);the values of NK,CD3+,CD4+and CD4+/CD8+of the obser-vation group increased compared with those before treatment(P＜0.05),and the increase was greater than that of the control group(P＜0.05);the CD8+value of the observation group decreased compared with that before treatment(P＜0.05),and the decrease was greater than that of the control group(P＜0.05).Conclusion Erlotinib combined with bevacizumab can sig-nificantly improve the levels of serum tumor markers and immune function in elderly patients with advanced NSCLC,and has certain clinical application value.