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中华临床医师杂志(电子版) ›› 2021, Vol. 15 ›› Issue (10) : 774 -778. doi: 10.3877/cma.j.issn.1674-0785.2021.10.010

临床研究

灰色筛选方改善中晚期非小细胞肺癌紫杉醇联合顺铂化疗相关不良反应的临床研究
牛静秀1, 张利红1, 王辉1,()   
  1. 1. 300121 天津,天津市人民医院肿瘤科
  • 收稿日期:2021-04-14 出版日期:2021-10-15
  • 通信作者: 王辉
  • 基金资助:
    天津市人民医院院内课题(2016YJ032)

Clinical study on the improvement of adverse reactions related to paclitaxel combined with cisplatin chemotherapy in advanced non-small cell lung cancer by grey screening method

Jingxiu Niu1, Lihong Zhang1, Hui Wang1,()   

  1. 1. Department of Oncology, Tianjin People's Hospital, Tianjin 300121, China
  • Received:2021-04-14 Published:2021-10-15
  • Corresponding author: Hui Wang
引用本文:

牛静秀, 张利红, 王辉. 灰色筛选方改善中晚期非小细胞肺癌紫杉醇联合顺铂化疗相关不良反应的临床研究[J/OL]. 中华临床医师杂志(电子版), 2021, 15(10): 774-778.

Jingxiu Niu, Lihong Zhang, Hui Wang. Clinical study on the improvement of adverse reactions related to paclitaxel combined with cisplatin chemotherapy in advanced non-small cell lung cancer by grey screening method[J/OL]. Chinese Journal of Clinicians(Electronic Edition), 2021, 15(10): 774-778.

目的

观察灰色筛选方改善中晚期非小细胞肺癌紫杉醇联合顺铂化疗相关不良反应的效果。

方法

入组2017年1月1日至2018年6月31日天津市人民医院收治的103例中晚期非小细胞肺癌患者,采用随机数字表法分为治疗组52例和对照组51例。治疗组接受灰色筛选方口服联合紫杉醇+顺铂静脉化疗2周期,对照组单纯给予紫杉醇+顺铂静脉化疗2周期。随后进行临床疗效、KPS评分、化疗不良反应、恶性肿瘤生活质量评估并比较。

结果

临床疗效方面,治疗组中完成治疗共50例,其中,完全缓解7例,部分缓解22例,稳定19例,进展2例;对照组完成治疗50例,其中,完全缓解3例,部分缓解16例,稳定26例,进展5例;治疗组治疗总有效率(58%)高于对照组(38%),差异有统计学意义(P<0.05)。不良反应方面治疗组与对照组相比存在轻度的骨髓抑制,安全性属于可控范围内。与对照组相比,治疗组能够有效减少患者胃肠道反应、肝功能不全等化疗副反应发生率,差异有统计学意义(P<0.05)。在KPS评分方面,治疗后治疗组KPS评分显著高于对照组[(70.91±14.45)分 vs(55.71±11.21)分],差异有统计学意义(P<0.05);亚组分析显示,治疗组气阴两虚证及阴虚内热证患者KPS评分显著高于对照组[(72.22±13.02)分 vs(57.14±7.56)分;(72.00±17.89)分 vs(53.75±10.61)分],差异均有统计学意义(P均<0.05)。在恶性肿瘤生活质量评估方面,治疗组较对照组而言,躯体、角色、情绪以及总体健康状况评分提高,失眠、便秘、腹泻、纳差评分降低,差异有统计学意义(P均<0.05)。

结论

灰色筛选方联合化疗能够减少非小细胞肺癌患者化疗不良反应,提高患者的生活质量,临床疗效可观。

Objective

To observe the clinical efficacy of grey screening method (GSC) on the improvement of adverse reactions related to paclitaxel combined with cisplatin chemotherapy in advanced non-small cell lung cancer.

Methods

A total of 103 hospitalized patients with advanced non-small cell lung cancer treated in Tianjin People's Hospital from January 1, 2017 to June 31, 2018 were selected and randomly divided into either a treatment group (52 cases) or a control group (51 cases). Patients in the treatment group were given GSC combined with intravenous chemotherapy with paclitaxel and cisplatin, while patients in the control group received intravenous chemotherapy with paclitaxel and cisplatin only. After two cycles of chemotherapy, the curative effect, Karnofsky performance scale (KPS) score, adverse reactions and quality of life were compared between the two group.

Results

Fifty patients in the treatment group completed the treatment, including 7 cases with complete response, 22 with partial response, 19 with stable disease and 2 with progressive disease. In the control group, 50 cases completed the treatment, including 3 cases with complete response, 16 with partial response, 26 with stable disease and 5 with progressive disease. The total effective rate of the treatment group (58%) was significantly higher than that in the control group (38%; P<0.05). In terms of adverse reactions, manageable mild bone marrow suppression was observed in the treatment group. Compared with the control group, the treatment group had a significantly reduced incidence of adverse reactions such as gastrointestinal reactions and liver dysfunction (P<0.05). The KPS score of the treatment group was significantly higher than that of the control group after treatment [(70.91±14.45) vs (55.71±11.21), P<0.05]. Subgroup analysis showed that the KPS scores of patients with syndrome of deficiency of both Qi and Yin and syndrome of endogenous heat due to Yin deficiency in the treatment group were significantly higher than those of the control group [(72.22±13.02) vs (57.14±7.56) and (72.00±17.89) vs (53.75±10.61), respectively; P<0.05 for both]. Regarding the quality of life with malignant tumors, compared with the control group, the scores of body, role, mood, and general health status in the treatment group were significantly improved, and the scores of insomnia, constipation, diarrhea, and poor appetite were significantly decreased (P<0.05).

Conclusion

GSC combined with chemotherapy in patients with advanced non-small cell lung cancer has reliable efficacy and can reduce the adverse reactions of chemotherapy and improve the quality of life.

表1 2组非小细胞肺癌患者临床疗效比较(例)
表2 2组非小细胞肺癌患者化疗不良反应比较(例)
表3 2组非小细胞肺癌不同证型患者治疗前后KPS评分比较(分,
xˉ
±s
表4 2组非小细胞肺癌患者生活质量评分比较(分,
xˉ
±s
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