吉非替尼治疗进展期非小细胞肺癌疗效分析及对血清MMP-9的影响

摘要

目的 探讨吉非替尼治疗进展期非小细胞肺癌(non-small cell lung cancer,NSCLC)的临床疗效、安全性以及对血清基质金属蛋白酶-9(matrix metalloproteinase-9,MMP-9)的影响.方法 依据纳入与排除标准,选取68例进展期NSCLC患者为研究对象.随机分为观察组与对照组,每组各34例.观察组予以口服吉非替尼;对照组予以GP方案.观察2组患者的临床疗效,包括客观缓解率(objective response rate,ORR)、疾病控制率(disease control rate,DCR) 、无进展生存期(progression free survival,PFS)与总生存期(overall survival,OS)等,治疗前后测定血清MMP-9的浓度,记录可能发生的不良反应.结果 观察组ORR达47.06%,DCR达76.47%,均高于对照组;观察组中位PFS为6.8个月,中位OS为12.3个月,均长于对照组;两组患者治疗后血清MMP-9水平均明显降低,且观察组治疗后血清MMP-9水平降低更显著;观察组与对照组不良反应发生率分别为14.71%、38.24%,观察组不良反应发生率显著低于对照组.上述差异均有统计学意义(P＜0.05或P＜0.01).结论 吉非替尼为进展期NSCLC的二、三线治疗提供了新的治疗方法,抑制了MMP-9的活性,具有较好的肿瘤抑制作用,且临床安全性高,比较适合于进展期NSCLC的临床治疗.%Objective To investigate the clinical efficacy of gefitinib for treatment of advanced non -small cell lung cancer ( NSCLC ) and the effect on serum matrix metalloproteinase -9( MMP -9 ). Methods Sixty - eight cases of NSCLC patients were selected according to included and excluded rules. The patients were randomly divided into two groups : observed group and control group with 34 cases in each group. Observed group was fed with gefitinib, Control group given GP plans. Clinical efficacy before and after treatment of the two groups were observed, including objective response rate( ORR ), disease control rate( DCR ), progression free survival( PFS ), overall survival( OS ) and so on. The concentration of serum MMP - 9 was determined and adverse reaction was recorded. Results In observed group, ORR was 47. 06% ,DCR was 76.47% ,the median PFS was 6. 8 months,the median OS was 12. 3 months,all of these parameters were higher than those of control group. The level of MMP - 9 after treatment of the two groups were decreased significantly, and observed group was more significantly, the adverse reaction in observed group ( 14. 71% ) was significantly lower than in control group ( 38. 24% ),these differences were statistically significant ( P < 0. 05 or P < 0. 01 ). Conclusion Gefitinib guides a new therapeutic scheme for those second and third line treatment of NSCLC, it inhibits the activity of MMP - 9, which lead to a significant effect on tumor inhibition with a high safty,it is a suitable clinical treatment for NSCLC.