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吉非替尼联合DP化疗方案同步3D-CRT对局部晚期非小细胞肺癌患者血清SCCAg、b FGF水平及生存周期的影响

Effect of gefitinib combined with DP chemotherapy and synchronous 3D-CRT on the serum levels of SCCAg and b FGF and survival cycle in patients with local advanced non-small cell lung cancer

摘要:

目的 探讨吉非替尼联合DP(多西紫杉醇+顺铂)化疗方案同步三维适形放疗(3D-CRT)在局部晚期非小细胞肺癌(NSCLC)治疗中的临床效果.方法 选取2012年5月至2014年10月本院58例局部晚期NSCLC患者,按照随机数字表法分为观察组(n=29)与对照组(n=29).对照组行DP化疗方案同步3D-CRT治疗,观察组在对照组基础上联合吉非替尼治疗.治疗3个月后,对比两组临床疗效、治疗前后血清人鳞状上皮细胞癌相关抗原(SCCAg)及碱性成纤维细胞生长因子(b FGF)、生存质量,随访3年,统计两组1年生存率、2年生存率、3年生存率及中位生存时间.结果 (1)临床疗效:观察组疗效总有效率68.97%(20/29)与对照组的48.28%(14/29)比较差异无统计学意义(P>0.05),但疾病控制率89.66%(26/29)高于对照组的65.52%(19/29)(P<0.05).(2)血清SCCAg、b FGF水平:治疗前两组血清SCCAg、b FGF水平比较差异无统计学意义(P>0.05),治疗后3个月两组血清SCCAg、b FGF水平较治疗前降低(P<0.05),且观察组低于对照组(P<0.05).(3)生存质量:治疗后3个月观察组生存质量优于对照组(P<0.05),且生存质量改善率51.72%(15/29)高于对照组24.14%(7/29)(P<0.05).(4)生存率:观察组中位生存时间为20.7个月,对照组中位生存时间为16.9个月.观察组1年生存率82.76%(24/29)高于对照组58.62% (17/29) (P<0.05),2年生存率48.28%(14/29)、3年生存率31.03%(9/29)与对照组2年生存率34.48%(10/29)、3年生存率13.79%(4/29)比较差异无统计学意义(P>0.05).结论 吉非替尼联合DP化疗方案同步3D-CRT治疗局部晚期NSCLC,可提高疾病控制率,降低血清SCCAg、b FGF水平,有利于改善患者生存质量、延长生存期限.

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abstracts:

Objective To investigate the clinical effect of gefitinib combined with DP (docetaxel + cisplatin) chemotherapy and synchronous three dimensional conformal radiotherapy (3D-CRT) in the treatment of local advanced non-small cell lung cancer (NSCLC).Methods A total of 58 cases of local advanced NSCLC patients in our hospital from May 2012 to October 2014 were divided into the observation group (n=29) and the control group (n=29) according to the random number table method.The control group was treated with DP chemotherapy and synchronous 3D-CRT,and the observation group was treated with gefitinib on the basis of the control group.After 3 months of treatment,the clinical efficacy,serum squamous cell carcinoma associated antigen (SCCAg),basic fibroblast growth factor (b FGF),and quality of life before and after the treatment of the two groups were compared.The two groups were followed up for 3 years,and the 1-year survival rate,2-year survival rate,3-year survival rate,and median survival time of the two groups were recorded.Results (1) Clinical efficacy:there was no statistically significant difference in the total efficiency between the observation group [68.97% (20/29)] and the control group [48.28% (14/29)] (P>0.05),but the rate of disease control [89.66% (26/29)]of the observation group was higher than that of the control group [65.52% (19/29)] (P<0.05).(2) Serum levels of SCCAg and b FGF:there were no statistically significant differences in serum levels of SCCAg and b FGF between the two groups before the treatment (P>0.05);after 3 months of treatment,the serum levels of SCCAg and b FGF in the two groups were lower than those before the treatment (P<0.05),and those in the observation group were lower than those in the control group (P<0.05).(3) Quality of life:after 3 months of treatment,the quality of life in the observation group was better than that in the control group (P<0.05),and the improvement rate of quality of life of the observation group [51.72% (15/29)] was higher than that of the control group [24.14% (7/29)] (P<0.05).(4) Survival rate:the median survival time of the observation group was 20.7 months,and the median survival time of the control group was 16.9 months.The 1-year survival rate of the observation group [82.76% (24/29)] was higher than that of the control group [58.62% (17/29)] (P<0.05),there were no statistically significant differences in the 2-year survival rate and the 3-year survival rate between the observation group and the control group [48.28% (14/29) vs.34.48% (10/29),31.03% (9/29) vs.13.79% (4/29)] (P>0.05).Conclusion Gefitinib combined with DP chemotherapy and synchronous 3D-CRT in the treatment of local advanced NSCLC can improve the rate of disease control and reduce the serum levels of SCCAg and b FGF.Besides,it is beneficial to improve the quality of life and prolong the life expectancy of the patients.

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