2024 年第 2 期 第 19 卷

甲磺酸奥希替尼联合常规培美曲塞二钠加卡铂化疗方法治疗晚期非小细胞肺癌的临床效果分析

Clinical effect analysis of osimertinib mesylate combined with pemetrexed disodium and carboplatin in treatment of advanced non-small cell lung cancer

作者：李小雪1谭晓刚2姚舒洋1农靖颖1张毅2

英文作者：Li Xiaoxue1 Tan Xiaogang2 Yao Shuyang1 Nong Jingying1 Zhang Yi2 

单位：1首都医科大学宣武医院胸部肿瘤内科，北京100053；2首都医科大学宣武医院胸科，北京100053

英文单位：1Department of Chest Oncology Xuanwu Hospital Capital Medical University Beijing 100053 China; 2Department of Chest Xuanwu Hospital Capital Medical University Beijing 100053 China

关键词：晚期非小细胞肺癌；甲磺酸奥希替尼；培美曲塞二钠；卡铂；疗效

英文关键词：Advancednon-smallcelllungcancer;Osimertinibmesylate;Pemetrexeddisodium;Carboplatin;Efficacy

• 摘要：

• 目的  探讨甲磺酸奥希替尼联合常规培美曲塞二钠加卡铂化疗方法治疗晚期非小细胞肺癌（NSCLC）的临床效果。方法  选取2018年10月至2023年1月首都医科大学宣武医院收治的105例晚期NSCLC患者为研究对象。依照随机数字表法分为对照组（52例）和观察组（53例）。对照组给予培美曲塞二钠加卡铂化疗，观察组在对照组基础上给予甲磺酸奥希替尼治疗，3周为1个疗程，2组均连续治疗2个疗程。治疗后进行疾病控制率评价，比较2组治疗前后的Karnofsky功能状态（KPS）评分、CD+3、CD+4水平、CD+4/CD+8比值及细胞角蛋白19片段（CYFRA21-1）、癌胚抗原、胸苷激酶1水平及治疗期间不良反应发生率。结果  观察组疾病控制率高于对照组［83.0%（44/53）比65.4%（34/52）］，差异有统计学意义（P<0.05）。治疗后观察组KPS评分高于对照组［（76±6）分比（64±6）分］；观察组CD+3、CD+4水平及CD+4/CD+8比值高于治疗前且高于对照组；2组CYFRA21-1、癌胚抗原、胸苷激酶1水平均低于治疗前且观察组低于对照组，差异均有统计学意义（均P<0.05）。治疗期间，观察组与对照组不良反应发生率差异无统计学意义［13.2%（7/53）比9.6%（5/52）］（P>0.05）。结论  甲磺酸奥希替尼联合常规培美曲塞二钠加卡铂化疗方法治疗晚期NSCLC的临床效果较好，有助于患者生活质量和免疫功能的提高，且具有较好的安全性。

• Objective  To investigate the clinical effect analysis of osimertinib mesylate combined with pemetrexed disodium and carboplatin in treatment of advanced non-small cell lung cancer(NSCLC). Methods  Totally 105 patients with advanced NSCLC admitted to Xuanwu Hospital Capital Medical University from October 2018 to January 2023 were selected. According to the random number table method, they were divided into control group (52 cases) and observation group(53 cases). The control group received chemotherapy with pemetrexed disodium and carboplatin, while the observation group received treatment with osimertinib mesylate on the basis of the control group. Both groups were treated for 2 courses, with 3 weeks as a course. After treatment, disease control rate evaluation was conducted, and the Karnofsky performance status (KPS) score, CD+3, CD+4 levels, CD+4/CD+8 ratio, cytokeratin 19 fragments (CYFRA21-1), carcinoembryonic antigen, thymidine kinase 1 levels before and after treatment, and incidence of adverse reactions during treatment was compared between the two groups. Results  The disease control rate in the observation group was higher than that in the control group［83.0%(44/53) vs 65.4%(34/52)］(P<0.05). After treatment, the KPS score in the observation group was higher than that in the control group［(76±6) vs (64±6)］; the levels of CD+3, CD+4, and CD+4/CD+8 ratio in the observation group were higher than those before treatment and higher than those in the control group; the levels of CYFRA21-1, carcinoembryonic antigen, and thymidine kinase 1 in the two groups were lower than those before treatment, and the observation group was lower than the control group(all P<0.05). During the treatment period, there was no statistically significant difference in the incidence of adverse reactions between the observation group and the control group［13.2%(7/53) vs 9.6%(5/52)］(P>0.05). Conclusion  ss  The clinical effect of osimertinib mesylate combined with pemetrexed disodium and carboplatin in treatment of advanced NSCLC is significant, which can significantly improve the quality of life and immune function, and has good safety.