达克替尼联合125I粒子植入治疗中晚期非小细胞肺癌的临床疗效分析

Clinical efficacy of dacomitinib combined with 125I seed implantation in treatment of advanced non-small cell lung cancer

摘要:

目的 探讨达克替尼联合¹²⁵I粒子植入治疗中晚期非小细胞肺癌（NSCLC）的临床疗效及生存率。方法 根据治疗方案的不同将117例中晚期NSCLC患者分为对照组和研究组。两组均给予顺铂化疗，对照组¹²⁵I粒子植入后化疗；研究组在¹²⁵I粒子植入后化疗并口服达克替尼，45 mg/次，1次/d。3个化疗周期后，评估两组的临床疗效，比较两组患者的癌胚抗原（CEA）、肿瘤细胞角质蛋白19片段抗原21-1（CYFRA21-1）及神经元特异性烯醇化酶（NSE）水平，比较两组患者的血管内皮生长因子（VEGF）及表皮生长因子受体（EGFR）水平，评估治疗方案的安全性，并进行生存分析。结果 治疗后，对照组的客观缓解率为68.97%（40/58），高于研究组的86.44%（51/59）（P <0.05）；CEA分别为（8.35±1.36）ng/mL、（5.27±1.03）ng/mL，CYFRA21-1分别为（5.84±1.08）ng/mL、（3.40±0.81）ng/mL，NSE分别为（11.24±3.05）ng/mL、（9.31±2.56）ng/mL；对照组和研究组的VEGF分别为（242.69±19.04）ng/L、（181.84±15.96）ng/L，EGFR分别为（139.03±15.01）ng/L、（105.12±13.48）ng/L，两组上述指标比较，差异有统计学意义（均P <0.05）。对照组和研究组¹²⁵I粒子植入不良反应率分别为10.34%和8.47%，药物治疗不良反应率分别为8.62%和16.95%，两组比较，差异无统计学意义（P >0.05）；研究组、对照组1年生存率分别为76.27%（45/59）、56.90%（33/58），平均生存时间分别为（11.69±0.11）个月、（10.92±0.25）个月，研究组与对照组的1年生存率比较，经Log rank χ² 检验，差异有统计学意义（χ² =5.380，P =0.020）。结论 达克替尼联合¹²⁵I粒子植入治疗能够有效提高中晚期NSCLC的疗效，安全性良好，同时能够改善患者预后。

Abstract:

Objective To investigate the clinical efficacy and survival analysis of Dacomitinib combined with ¹²⁵I seed implantation in the treatment of advanced non-small cell lung cancer (NSCLC).Methods According to different treatment regimens, 117 patients with advanced NSCLC were divided into control group (58 cases) and study group (59 cases). Both groups were given cisplatin chemotherapy, and the control group was given chemotherapy after ¹²⁵I seed implantation; the study group was given chemotherapy and oral Dacomitinib after ¹²⁵I seed implantation, 45 mg/time, once a day. After 3 cycles of chemotherapy, the clinical efficacy of the two groups was evaluated, the levels of tumor markers and vascular endothelial indexes were compared between the two groups, the safety of the treatment regimen was observed, and survival analysis was performed.Results After treatment, the ORR of the study group was 68.97% (40/58), which was higher than that of the control group 86.44% (51/59) (P < 0.05). The levels of CEA, CYFRA21-1, and NSE in the control group and the study group were (8.35±1.36) ng/mL and (5.27±1.03) ng/mL, (5.84±1.08) ng/mL and (3.40±0.81) ng/mL, and (11.24±3.05) ng/mL and (9.31±2.56) ng/mL, respectively. The levels of VEGF and EGFR in the control group and the study group were (242.69±19.04) ng/L and (181.84±15.96) ng/L, and (139.03±15.01) ng/L and (105.12±13.48) ng/L. The above indicators were compared between the control group and the research group, and the differences were statistically significant (all P < 0.05). The adverse reaction rates of ¹²⁵I seed implantation in the control group and the study group were 10.34% and 8.47%. The adverse reaction rates of chemotherapy and targeted therapy were 8.62% and 16.95%. There was no significant difference in the above indicators between the two groups (P > 0.05). The 1-year survival rates of the study group and control group were 76.27% (45/59) and 56.90% (33/58), and the average survival time was (11.69±0.11) months and (10.92±0.25) months. The 1-year survival curve between the group and the control group was compared with the Log rank test, and the difference was statistically significant (χ² = 5.380, P = 0.020).Conclusion Dacomitinib combined with ¹²⁵I seed implantation therapy can effectively improve the curative effect of patients with advanced NSCLC, improve the level of tumor markers and vascular endothelial indexes, with good safety, and can improve the prognosis of patients.