125I粒子植入联合表皮生长因子受体酪氨酸激酶抑制剂治疗晚期非小细胞肺癌的临床分析。

Q2 Medicine Journal of Buon Pub Date : 2021-09-01

Xiaoshan Wang, Dong Wang

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引用次数: 0

摘要

目的:探讨125I放射性粒子植入联合表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKIs)治疗晚期非小细胞肺癌(NSCLC)的疗效和安全性。方法:108例EGFR突变阳性的晚期非小细胞肺癌(IIIB-IV期)患者随机分为125I组(125I放射性粒子植入联合EGFR- tkis治疗，n=54)和EGFR- tkis组(单独EGFR- tkis治疗，n=54)。分析和评价近期疗效和不良反应，分析外周血T淋巴细胞亚群、自然杀伤细胞(NK)及相关免疫炎症因子水平的变化，记录长期生存和疾病进展情况。结果:125I组和EGFR-TKIs组的客观有效率分别为61.1%(33/54)和51.9%(28/54)，疾病控制率分别为88.9%(48/54)和68.5%(37/54)。治疗后6个月，两组患者外周血分化簇3+ (CD3+)、CD4+、CD4+/CD8+、NK细胞水平均较治疗前显著升高(p结论:125I放射性粒子植入联合EGFR-TKIs治疗晚期NSCLC安全有效，近期疗效和远期生存率均明显优于单用EGFR-TKIs治疗。同时调节患者体内T淋巴细胞亚群、NK细胞及免疫炎性因子的表达，提高患者免疫功能。

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Clinical analysis of 125I seed implantation combined with epidermal growth factor receptor-tyrosine kinase inhibitors in advanced non-small cell lung cancer.

Purpose: To explore the efficacy and safety of 125I radioactive seed implantation combined with epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) in the treatment of advanced non-small cell lung cancer (NSCLC).

Methods: 108 patients with EGFR mutation-positive unresectable advanced NSCLC (stage IIIB-IV) were randomly divided into 125I group (treated with 125I radioactive seed implantation combined with EGFR-TKIs, n=54) and EGFR-TKIs group (treated with EGFR-TKIs alone, n=54). The short-term efficacy and adverse reactions were analyzed and evaluated, the changes in the levels of peripheral blood T lymphocyte subsets, natural killer (NK) cells and related immune-inflammatory factors were analyzed, and the long-term survival and progression of disease were recorded.

Results: The objective response rate was 61.1% (33/54) and 51.9% (28/54), and the disease control rate was 88.9% (48/54) and 68.5% (37/54), respectively, in 125I group and EGFR-TKIs group. At 6 months after treatment, the levels of peripheral blood cluster of differentiation 3+ (CD3+), CD4+, CD4+/CD8+ and NK cells significantly rose in both groups compared with those before treatment (p<0.05), while the levels of CD8+, serum tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), interleukin-6 (IL-6) and IL-10 significantly declined compared with those before treatment. The 2-year overall survival (OS) rate was 53.7% (29/54) and 40.7% (22/54), and the median progression-free survival (PFS) was 14.5 months and 9.8 months, respectively, in 125I group and EGFR-TKIs group.

Conclusions: 125I radioactive seed implantation combined with EGFR-TKIs is safe and effective in the treatment of advanced NSCLC, and its short-term efficacy and long-term survival rate of patients are significantly superior to those of EGFR-TKIs alone. At the same time, it can regulate the expressions of T lymphocyte subsets, NK cells and immune-inflammatory factors in patients, and improve their immune function.

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来源期刊

Journal of Buon 医学-肿瘤学

自引率

0.00%

发文量

审稿时长

4-8 weeks

期刊介绍： JBUON aims at the rapid diffusion of scientific knowledge in Oncology. Its character is multidisciplinary, therefore all aspects of oncologic activities are welcome including clinical research (medical oncology, radiation oncology, surgical oncology, nursing oncology, psycho-oncology, supportive care), as well as clinically-oriented basic and laboratory research, cancer epidemiology and social and ethical aspects of cancer. Experts of all these disciplines are included in the Editorial Board. With a rapidly increasing body of new discoveries in clinical therapeutics, the molecular mechanisms that contribute to carcinogenesis, advancements in accurate and early diagnosis etc, JBUON offers a free forum for clinicians and basic researchers to make known promptly their achievements around the world. With this aim JBUON accepts a broad spectrum of articles such as editorials, original articles, reviews, special articles, short communications, commentaries, letters to the editor and correspondence among authors and readers. JBUON keeps the characteristics of its former paper print edition and appears as a bimonthly e-published journal with continuous volume, issue and page numbers.