贝伐珠单抗联合靶向治疗对EGFR突变型非小细胞肺癌患者的疗效观察

蒋一玲; 张传领; 陈承; 余洪金; 李薇娜; 方晶; 方勇

doi:10.16766/j.cnki.issn.1674-4152.002047

贝伐珠单抗联合靶向治疗对EGFR突变型非小细胞肺癌患者的疗效观察

doi: 10.16766/j.cnki.issn.1674-4152.002047

1.
浙江萧山医院肿瘤内科，浙江杭州 311201
2.
浙江邵逸夫医院肿瘤内科，浙江杭州 311201

基金项目:

浙江省医药卫生科技计划项目 2019RC256

详细信息

通讯作者:
方勇, E-mail: fangyzju@163.com

中图分类号: R734.2 R730.7
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- 文章访问数: 319
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- PDF下载量: 8
- 被引次数: 0
出版历程
- 收稿日期: 2021-09-25
- 网络出版日期: 2022-02-16

Observation of curative effect of bevacizumab combined with targeted treatment of EGFR mutant lung cancer

1.
Department of Oncology, Zhejiang Xiaoshan Hospital, Hangzhou, Zhejiang 311201, China

摘要

摘要: 目的探讨贝伐珠单抗联合靶向治疗对表皮生长因子受体(EGFR)突变型非小细胞肺癌(NSCLC)患者近远期预后及免疫状态、不良反应的影响，以期为临床治疗方法的选择提供参考。方法选择2017年9月—2018年9月在浙江萧山医院和浙江省邵逸夫医院接受诊治的EGFR突变型NSCLC患者80例，按照随机数字表法分为对照组和观察组，每组各40例。对照组采用盐酸埃克替尼片治疗，观察组采用贝伐珠单抗联合盐酸埃克替尼片治疗。比较2组患者临床疗效、肿瘤标记物水平、免疫指标水平，并对2组患者生存情况、不良反应情况进行比较。结果观察组疾病控制率(DCR)明显高于对照组(P < 0.05)。治疗后，2组血管内皮生长因子(VEGF)、糖类抗原125(CA125)、细胞角蛋白19片段(CYFRA21-1)水平均明显低于治疗前，且观察组均明显低于对照组(P < 0.05)。治疗后，2组CD3⁺、CD4⁺/CD8⁺水平均明显高于治疗前，且观察组均明显高于对照组(P < 0.05)。观察组患者的生存情况优于对照组(P < 0.05)。观察组不良反应总发生率明显低于对照组(P < 0.05)。结论贝伐珠单抗联合盐酸埃克替尼治疗EGFR突变型NSCLC患者疗效显著，可有效抑制肿瘤细胞增殖，缩小肿瘤体积，改善机体免疫功能，提高患者生存率。
- 贝伐珠单抗 /
- 靶向治疗 /
- 表皮生长因子受体突变型 /
- 非小细胞肺癌 /
- 预后
Abstract: Objective To investigate the effect of bevacizumab combined with targeted therapy on the short- and long-term prognosis, immune status, and side effects of patients with epidermal growth factor receptor (EGFR) mutant non-small cell lung cancer (NSCLC), in order to provide reference for the choice of clinical treatment. Methods A total of 80 EGFR-mutant NSCLC patients who were diagnosed and treated in our hospital from September 2017 to September 2018 were selected and divided into control group and observation group according to the random number table method, with 40 cases in each group. The control group was treated with icotinib hydrochloride tablets, and the observation group was treated with bevacizumab combined with icotinib hydrochloride tablets. The clinical efficacy, tumor marker levels, and immune index levels were compared between the two groups of patients, and the survival and toxicity of the two groups were compared. Results The disease control rate (DCR) of the observation group was significantly higher than that of the control group (P < 0.05). After treatment, the levels of vascular endothelial growth factor (VEGF), carbohydrate antigen 125 (CA125), and cytokeratin 19 fragment (CYFRA21-1) in the two groups were significantly lower than those before treatment, and the observation group were significantly lower than those in the control group (P < 0.05). After treatment, the levels of CD3⁺, CD4⁺/CD8⁺ in the two groups were significantly higher than those before treatment, and the observation group were significantly higher than those in the control group (P < 0.05). The survival of patients in the observation group was better than that of the control group (P < 0.05). The total incidence of side effects in the observation group was significantly lower than that in the control group (P < 0.05). Conclusion Bevacizumab combined with icotinib hydrochloride in the treatment of EGFR mutant NSCLC patients has a significant effect, which can effectively inhibit the proliferation of tumor cells, reduce the tumor volume, improve the body's immune function, and improve the survival rate of patients.
- Bevacizumab /
- Targeted therapy /
- Epidermal growth factor receptor mutant /
- Non-small cell lung cancer /
- Prognosis

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图 1 2组NSCLC患者生存情况比较

下载: 全尺寸图片幻灯片

表 1 2组NSCLC患者一般资料比较

组别	例数	年龄(x±s，岁)	性别(例)		肿瘤直径(x±s，cm)	病理分期(例)		病理类型(例)
组别	例数	年龄(x±s，岁)	男性	女性	肿瘤直径(x±s，cm)	Ⅲb	Ⅳ	腺癌	鳞癌
对照组	40	61.33±6.23	25	15	3.88±0.85	15	25	27	13
观察组	40	60.18±5.89	23	17	3.72±0.79	14	26	28	12
统计量		0.848^a	0.208^b		0.872^a	0.594^b		0.058^b
P值		0.399	0.648		0.386	0.441		0.809
注：^a为t值，^b为χ²值。

下载: 导出CSV

表 2 2组NSCLC患者疗效比较 [例(%)]

组别	例数	CR	PR	SD	PD	DCR
对照组	40	7(15.56)	13(32.50)	7(15.56)	13(32.50)	27(67.50)
观察组	40	12(30.00)	15(37.50)	9(22.50)	4(10.00)	36(90.00)
注：2组疾病控制率比较，χ²=6.050，P=0.014。

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表 3 2组NSCLC患者肿瘤标记物水平比较(x±s)

组别	例数	CYFRA21-1(μg/L)		CA125(U/mL)		VGEF(ng/L)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	40	40.33±7.23	24.42±5.23^a	87.75±10.71	52.21±9.21^a	538.25±100.39	331.31±85.61^a
观察组	40	39.87±7.51	17.58±4.08^a	88.25±11.13	41.89±8.78^a	531.79±98.26	271.58±79.94^a
t值		0.279	6.522	-0.204	5.129	0.291	3.225
P值		0.781	<0.001	0.838	<0.001	0.772	0.002
注：与治疗前比较，^aP < 0.05。

下载: 导出CSV

表 4 2组NSCLC患者免疫指标水平比较(x±s)

组别	例数	CD3⁺(%)		CD4⁺/CD8⁺
组别	例数	治疗前	治疗后	治疗前	治疗后
对照组	40	55.33±3.23	70.74±3.87^a	1.11±0.29	1.74±0.47^a
观察组	40	54.39±2.98	75.74±3.58^a	1.08±0.38	2.49±0.51^a
t值		1.353	-5.170	0.397	-6.839
P值		0.180	<0.001	0.693	<0.001
注：与治疗前比较，^aP<0.05。

下载: 导出CSV

表 5 2组NSCLC患者不良反应比较 [例(%)]

组别	例数	恶心呕吐	高血压	血小板减少	神经毒性	总发生
对照组	40	4(10.00)	3(7.50)	3(7.50)	2(2.50)	12(30.00)
观察组	40	2(5.00)	1(2.50)	1(2.50)	0(0.00)	4(10.00)
注：2组患者不良反应发生率比较，χ²=5.000，P=0.025。

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