安罗替尼联合TP方案对晚期NSCLC患者炎症反应及肿瘤标志物的影响OA
Effects of Anlotinib Combined with TP Chemotherapy Regimen on Inflammatory Response and Tumor Markers in Patients with Advanced Non-Small Cell Lung Cancer
目的:探讨在标准紫杉醇联合顺铂(TP)化疗方案基础上加入安罗替尼治疗对晚期进展性非小细胞肺癌(NSCLC)患者的效果,并进一步分析其对血清炎症因子与肿瘤相关标志物的调控作用.方法:回顾性分析2020年4月至2025年4月在我院确诊并接受系统治疗的94例晚期进展性NSCLC患者.其中47例接受常规TP方案化疗(对照组),另外47例在TP化疗基础上加用安罗替尼(观察组).比较两组患者的实体瘤疗效与安全性,并随访12个月,统计生存情况、无进展生存期(PFS)和总生存期(OS).采用Kaplan-Meier法绘制生存曲线,并通过Log-rank检验比较两组间PFS及OS差异.另于治疗前及4个疗程后检测血清中肿瘤[癌胚抗原(CEA)、糖类抗原125(CA125)、细胞角蛋白19片段(Cyfra21-1)]与炎症[白细胞介素-2(IL-2)、IL-10、干扰素-γ(IFN-γ)]相关因子水平.结果:治疗结束后,观察组疾病控制率(DCR)优于对照组(P＜0.05).安全性方面,观察组患者在治疗期间出现蛋白尿及高血压的总发生率高于对照组(P＜0.05).随访结果显示,对照组PFS为(6.95±1.71)个月,死亡28例,OS为(7.42±1.67)个月;观察组PFS为(8.26±2.34)个月,死亡17例,OS为(10.63±1.92)个月,二者差异均有统计学意义(x2=7.986、8.012,P＜0.05).治疗后,两组CEA、CA125、Cyfra21-1及IL-10水平均下降,而IL-2与IFN-γ水平均较治疗前升高,且观察组变化更为突出(P＜0.05).结论:在TP化疗方案中联合安罗替尼用于晚期进展性NSCLC的治疗,可显著提高疾病控制率,并有效延长PFS与OS.同时,该联合方案在降低肿瘤标志物水平、改善炎症因子平衡方面亦表现出积极作用,提示其可能通过调节免疫微环境减轻肿瘤负担.安罗替尼的使用也伴随一定的不良反应风险,如蛋白尿与高血压,临床中应加强个体化监测与用药.
Objective:To evaluate the efficacy of anlotinib in combination with standard paclitaxel plus cisplatin(TP)chemotherapy in patients with advanced progressive non-small cell lung cancer(NSCLC),and to explore its effects on serum inflammatory cytokines and tumor markers.Methods:A retrospective analysis was conducted on 94 patients with advanced progressive NSCLC who were diagnosed and received systematic treatment in our hospital from April 2020 to April 2025.Among them,47 patients received standard TP chemo-therapy(control group),while the other 47 patients received TP chemotherapy combined with oral anlotinib(observation group).Tumor response and safety were compared between the two groups,and the patients were followed up for 12 months to assess survival outcomes,including progression-free survival(PFS)and overall survival(OS).Survival curves were plotted using the Kaplan-Meier method,and PFS and OS of the two groups were compared through the Log-rank test.Serum levels of tumor markers[carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125),cytokeratin 19 fragment(Cyfra21-1)]and inflammatory factors[interleukin-2(IL-2),IL-10,interferon-γ(IFN-γ)]were measured before treatment and after four cycles of therapy.Results:After treatment,the disease con-trol rate(DCR)in the observation group was significantly higher than that in the control group(P＜0.05).Regarding safety,the overall incidence of proteinuria and hypertension in the observation group during treatment was higher than that in the control group(P＜0.05).Follow-up results showed that the control group had a PFS of 6.95±1.71 months with 28 deaths and an OS of 7.42±1.67 months;the observation group had a PFS of 8.26±2.34 months with 17 deaths and an OS of 10.63±1.92 months.Differences between the two groups were statistically significant(x2=7.986,8.012,P＜0.05).After treatment,levels of CEA,CA125,Cyfra21-1,and IL-10 decreased in both groups,whereas IL-2 and IFN-γ increased compared with pre-treatment levels,with more pronounced changes observed in the observation group(P＜0.05).Conclusion:The addition of anlotinib to TP chemotherapy significantly improves disease control,extends PFS and OS,and modulates tumor marker levels and inflammatory responses in advanced progressive NSCLC,suggesting a poten-tial immunomodulatory role in the tumor microenvironment.However,anlotinib is associated with increased risks of proteinuria and hyper-tension,warranting careful monitoring and individualized management.
胡斌;董良
河南省中医院肿瘤科,河南郑州 450002河南省中医院肿瘤科,河南郑州 450002
医药卫生
非小细胞肺癌晚期进展紫杉醇-顺铂安罗替尼生存获益炎症因子肿瘤标志物
Non-small cell lung cancerAdvanced progressionPaclitaxel-cisplatinAnlotinibSurvival benefitInflammatory cytokinesTumor markers
《中国药物评价》 2026 (1)
56-61,6
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