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厄科替尼治疗晚期非小细胞肺癌时早期联合局部放疗和 GM-CSF 的疗效。

Efficacy of early combination of local radiotherapy and GM-CSF for advanced non-small cell lung cancer treated with icotinib.

机构信息

Departments of Oncology, The Second People's Hospital of Yibin, No.268 Nanguang Road, Cuiping District, Yibin, 644000, Sichuan Province, China.

Department of Oncology, The Guizhou Provincial People's Hospital, Guiyang, Guizhou Province, China.

出版信息

Ir J Med Sci. 2020 Aug;189(3):791-797. doi: 10.1007/s11845-019-02137-x. Epub 2019 Dec 3.

Abstract

BACKGROUND

Lung cancer is a disease that severely endangers human health. Non-small cell lung cancer (NSCLC) accounts for approximately 4/5 of lung cancers.

AIMS

To investigate the efficacy of early combination of local radiotherapy and granulocyte macrophage colony-stimulating factor (GM-CSF) for advanced NSCLC treated with icotinib.

METHODS

Forty-two patients with stage IV NSCLC complicated with EGFR gene mutation were selected and randomly divided into two groups, with 21 patients in each group. Patients in control group were treated with icotinib, and patients in experimental group were treated with icotinib combined with local radiotherapy and subcutaneous injection of GM-CSF. One-year progression free survival between two groups was compared.

RESULTS

Three months after treatment, the efficacy in experimental group was significantly better than that in control group, and objective response rate was 95.24% in experimental group, which was higher than the 71.43% in control group. Patients in experimental group had no differences in white blood cell and neutrophil, but had significantly lower carcino-embryonic antigen and neuron-specific enolase levels and higher CD3+, CD4+, and CD4+/CD8+ than those in control group and before treatment. There were no differences in the proportion of patients with adverse reactions between two groups. One-year progression free survival was significantly better in experimental group than in control group.

CONCLUSIONS

Early combination of local radiotherapy and GM-CSF has a significant efficacy for advanced NSCLC accounts for approximately 4/5 of lung cancers treated with icotinib, and it can improve patients' autoimmunity and lengthen progression free survival.

摘要

背景

肺癌是严重危害人类健康的疾病,非小细胞肺癌(NSCLC)约占肺癌的 4/5。

目的

探讨吉非替尼治疗晚期 NSCLC 时早期联合局部放疗和粒细胞巨噬细胞集落刺激因子(GM-CSF)的疗效。

方法

选择 42 例 IV 期 NSCLC 合并 EGFR 基因突变患者,随机分为两组,每组 21 例。对照组给予吉非替尼治疗,实验组给予吉非替尼联合局部放疗和皮下注射 GM-CSF。比较两组患者的 1 年无进展生存期。

结果

治疗 3 个月后,实验组疗效明显优于对照组,实验组客观缓解率为 95.24%,高于对照组的 71.43%。实验组患者白细胞和中性粒细胞无差异,但癌胚抗原和神经元特异性烯醇化酶水平明显低于对照组和治疗前,CD3+、CD4+和 CD4+/CD8+明显高于对照组和治疗前。两组不良反应发生率无差异。实验组 1 年无进展生存期明显长于对照组。

结论

早期联合局部放疗和 GM-CSF 对吉非替尼治疗的晚期 NSCLC 具有显著疗效,可改善患者的自身免疫功能,延长无进展生存期。

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