RESUMO
Objective:To observe the efficacy of apatinib combined with first-line chemotherapy and maintenance therapy of only apatinib in patients with extensive small-cell lung cancer.Methods:The clinical data of 56 newly diagnosed patients with extensive small-cell lung cancer in the Fifth People′s Hospital of Dalian City from January 2018 to June 2019 were retrospectively analyzed. Among them, 27 patients (experimental group) were treated with first-line chemotherapy combined with apatinib, and 29 patients (control group) were treated with first-line chemotherapy alone. In experimental group, the expression levels of vascular endothelial growth factor (VEGF) and vascular endothelial growth factor receptor (VEGFR)-2 1 day before chemotherapy and 1 day after chemotherapy were detected by enzyme linked immunosorbent assay method. Response evaluation criteria in solid tumor (RECIST) was used to evaluate the efficacy. The occurrence of adverse reaction was recorded. The patients were followed up for 12 to 24 months, and progression-free survival and 1-year survival were recorded.Results:The objective response rate, median progression-free survival time and 1-year survival rate in experimental group were significantly higher than those in control group: 81.5% (22/27) vs. 55.2% (16/29), 10.5 months vs. 8.5 months and 81.5% (22/27) vs. 55.2% (16/29), and there were statistical differences ( P<0.05); there was no statistical difference in disease control rate between 2 groups ( P>0.05). In experimental group, the patients with complete response and partial response after chemotherapy were classified as effective subgroup (22 cases), and the patients with stationary disease and progressive disease were classified as ineffective subgroup (5 cases). There were no statistical difference in VEGF and VEGFR-2 before chemotherapy between 2 subgroups ( P>0.05). The VEGF and VEGFR-2 in effective subgroup were significantly lower than those in ineffective subgroup: (275.34 ± 16.15) ng/L vs. (330.24 ± 23.21) ng/L and (89.35 ± 4.34) ng/L vs. (112.34 ± 5.45) ng/L, and there were statistical differences ( P<0.01). There were no uncontrollable adverse reactions in 2 groups, and there was no statistical difference in the incidence of adverse reactions between 2 groups ( P>0.05). Conclusions:Application of apatinib in first-line therapy and maintenance therapy for patients with extensive small-cell lung cancer can improve clinical efficacy and survival benefit with controllable adverse reactions.
RESUMO
Objective:To investigate the effect of pidotimod in reducing pulmonary infection in patients with lung cancer undergoing chemotherapy.Methods:One hundred and twenty patients with lung cancer in the Fifth People′s Hospital of Dalian City from July 2017 to July 2018 were selected. The patients were divided into control group and pidotimod group by random digits table method with 60 cases each. The patients were treated with standard two drugs chemotherapy containing platinum drug according to the pathological type, and the patients in pidotimod group were combined with pidotimod. The number of pulmonary infections during chemotherapy, number of completed scheduled chemotherapy and adverse reaction were observed. The correlation between pulmonary infection and pidotimod was analyzed by multivariate orderly Logistic regression.Results:The incidence of pulmonary infection in pidotimod group was significantly lower than that in control group: 18.33% (11/60) vs. 40.00% (24/60), and there was statistical difference ( χ2 = 6.845, P<0.01). The rate of completed scheduled chemotherapy in pidotimod group was significantly higher than that in control group: 55.00% (33/60) vs. 36.67% (22/60), and there was statistical difference ( χ2 = 4.062, P<0.05). Multivariate orderly Logistic regression analysis result showed that pidotimod could reduce the risk of pulmonary infection ( OR = 0.210, 95% CI 0.072 to 0.606, P = 0.004), and help to complete the scheduled chemotherapy ( OR = 2.323, 95% CI 1.080 to 5.003, P = 0.031). In pidotimod group, no obvious adverse reaction related to pidotimod application was detected, and chemotherapy was not affected. Conclusions:Application of pidotimod can reduce the chance of pulmonary infection in patients with lung cancer undergoing chemotherapy and help patients complete scheduled chemotherapy.