沙利度胺联合埃克替尼治疗进展期肺腺癌的临床研究

doi:10.16689/j.cnki.cn11-9349/r.2019.02.012

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摘要目的探讨沙利度胺联合埃克替尼治疗肺腺癌的疗效和安全性。方法收集2013年1月1日至2015年6月30日医院收治的确诊为进展期肺腺癌的患者作为研究对象。随机分为试验组33例和对照组30例，试验组给予埃克替尼联合沙利度胺治疗；对照组给予埃克替尼单药治疗。比较两组肺腺癌患者治疗反应率、疾病无进展生存期以及治疗1疗程后血清相关分子血管内皮生长因子、白细胞介素-8、肿瘤坏死因子-α、碱性成纤维细胞生长因子的水平，以及不良事件在两组患者中的发生情况。结果两组患者皮疹、腹泻、肝功能损伤、肾功能损伤、血常规异常的发生率无明显差异，试验组大便隐血的发生率较对照组高。对照组30例肺腺癌患者，客观缓解率ORR为43.33%，而试验组达69.70%，差异有统计学意义(P＜0.05)。试验组疾病无进展生存期为（21.12±6.56）月，对照组疾病无进展生存期为（19.77±6.61）月(P=0.073)。对照组血清血管内皮生长因子水平为295.0 (122.67~572.54)pg/ml，试验组血清血管内皮生长因子水平为148.0 (56.33~337.42)pg/ml，显著低于对照组，差异有统计学意义(P<0.01)。白细胞介素-8、肿瘤坏死因子-α、碱性成纤维细胞生长因子水平两组间(P=0.0585)无统计学差异，但试验组白细胞介素-8、肿瘤坏死因子-α均低于对照组，碱性成纤维细胞水平试验组要高于对照组，提示两组实验数据存在差异的趋势。结论相比仅接受埃克替尼治疗组，沙利度胺联合埃克替尼可提高进展期肺腺癌患者的近期疗效。试验组疾病无进展生存期相比对照组略有延长，但无统计学差异。试验组患者未见严重毒副反应，患者耐受性好，可以作为治疗进展期肺腺癌的新型治疗手段。

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	江茜
	汪毅
	孙祥

关键词 ：沙利度胺, 埃克替尼, 进展期肺腺癌, 疗效评价, 不良反应

Abstract：Objective To observe the efficacy and toxicities of thalidomide plus icotinib in the treatment of advanced pulmonary adenocarcinoma. Methods Totally 63 patients with pulmonary adenocarcinoma in the third affiliated hospital of Anhui medical college were selected for study from January 2013 to June 2015. The patients were randomly divided into control and experimental groups， control group of 30 patients received icotinib； the experimental groups， 33 cases received thalidomide combined with icotinib. The clinical efficacy， adverse reactions， survival rate and the changes of the serum vascular endothelial growth factor (VEGF)， interleukin-8(IL-8) tumor necrosis factor α (TNF-α)； fibroblast growth factor (bFGF) of the two groups were observed and compared. Results No significant differences were found in adverse reactions， such as rash， diarrhea， abnormal liver and renal function and occurrence of bone narrow suppression of both groups. The incidence of occult blood of stool in experimental groups were higher than the control groups. The objective response rate (ORR) of the control group was 43.33%， while that of the experimental group was 69.70% (P<0.05). The PFS of the experimental group was 21.12±6.56 months， while that of the control group was 19.77±6.61 months (P=0.073). The VEGF levels in the control groups were significantly lower than the experimental groups 295.0 (122.67~572.54)vs 148.0 (56.33~337.42) pg/ml(P<0.01). IL-8， TNF-α and bFGF levels between the two groups (P=0.0585)， there was no statistical difference. But IL-8 and TNF-α levels in the experimental group were lower than the control group， and bFGF levels in the experimental group were higher than the control group， suggesting a trend of difference between the two groups. Conclusion Thalidomide combining with icotinib hydrochloride is effective and well tolerated in patients with advanced pulmonary adenocarcinoma. It may be a rational choice for the standard and individualized treatment of advanced pulmonary adenocarcinoma.

Key words： Thalidomide Icotinib hydrochloride Pulmonary adenocarcinoma Therapeutic evaluation Adverse reactions

基金资助:2013年度《安徽省年度重点科研计划项目》（1301043046）

通讯作者: 孙祥，电子邮箱：s883@sina.com

引用本文:

江茜，汪毅，孙祥. 沙利度胺联合埃克替尼治疗进展期肺腺癌的临床研究[J]. 肿瘤代谢与营养电子杂志, 2019, 6(2): 216-220.
JIANG Qian， WANG Yi， SUN Xiang. Clinical study of thalidomide plus Icotinib hydrochloride in the treatment of advanced pulmonary adenocarcinoma. Electron J Metab Nutr Cancer, 2019, 6(2): 216-220.

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