文献类型：期刊文献

中文题名：安罗替尼对二线靶向治疗耐药表皮生长因子受体突变晚期肺腺癌患者免疫功能的影响

英文题名：Effect of anlotinib on immune function of second-line targeted drug-resistant advanced lung adenocarcinoma with epidermal growth factor receptor mutation

作者：杨国彪[1];杨飞燕[1];张聪聪[1]

机构：[1]绍兴文理学院附属医院呼吸与危重症医学科,绍兴312000

年份：2025

卷号：48

期号：6

起止页码：555

中文期刊名：中国医师进修杂志

外文期刊名：Chinese Journal of Postgraduates of Medicine

语种：中文

中文关键词：肺腺癌;放射治疗计划,计算机辅助;突变;表皮生长因子受体;安罗替尼

外文关键词：Adenocarcinoma of lung;Radiotherapy planning,computer-assisted;Mutation;Epidermal growth factor receptor;Anlotinib

中文摘要：目的探讨安罗替尼联合放疗对二线靶向治疗后发生耐药的表皮生长因子受体(EGFR)突变晚期肺腺癌患者的治疗价值。方法前瞻性选择2021年7月至2023年7月绍兴文理学院附属医院收治的二线靶向治疗后耐药的150例EGFR突变晚期肺腺癌患者为研究对象,采用随机数字表法分为对照组和研究组,每组75例,对照组采用放疗,研究组采用安罗替尼联合放疗,比较两组近期临床效果和肿瘤指标、细胞免疫指标水平及不良反应发生情况。结果研究组治疗后客观缓解率(ORR)和疾病控制率(DCR)高于对照组[53.33%(40/75)比34.67%(26/75)、86.67%(65/75)比64.00%(48/75)],差异有统计学意义(χ^(2)=5.30、10.37,P<0.05)。研究组治疗后血管内皮生长因子、细胞角蛋白21-1片段和癌胚抗原水平低于对照组[(472.93±45.71)ng/L比(510.26±50.49)ng/L、(4.82±1.13)μg/L比(5.25±1.34)μg/L、(5.65±1.24)μg/L比(6.17±1.42)μg/L],差异有统计学意义(P<0.05)。研究组治疗后CD_(3)^(+)、CD_(4)^(+)及CD_(4)^(+)/CD_(8)^(+)水平高于对照组,CD_(8)^(+)水平低于对照组[0.532±0.044比0.508±0.041、0.321±0.030比0.305±0.027、1.02±0.19比0.93±0.16、0.303±0.040比0.320±0.044],差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论安罗替尼联合放疗可增强二线靶向治疗耐药EGFR突变晚期肺腺癌的临床效果,改善肿瘤指标,促进免疫功能恢复,不良反应无显著增加。

外文摘要：Objective To investigate the value of anlotinib combined with radiotherapy in second-line targeted drug-resistant advanced lung adenocarcinoma with epidermal growth factor receptor(EGFR)mutation.Methods A total of 150 patients with advanced lung adenocarcinoma with EGFR mutation who were resistant to second-line targeted therapy and admitted to the Affiliated Hospital of Shaoxing University from July 2021 to July 2023 were prospectively selected as the study objects,and they were divided into the control group and the study group by random number table method,with 75 cases in each group.The control group received radiotherapy,and the study group received anrotinib combined radiotherapy.The recent clinical effects,tumor indexes,cellular immune indexes and the occurrence of adverse reactions were compared between the two groups.Results After treatment,the objective response rate(ORR)and disease control rate(DCR)in the study group were higher than those in the control group:53.33%(40/75)vs.34.67%(26/75),86.67%(65/75)vs.64.00%(48/75),there were statistical differences(χ^(2)=5.30,10.37,P<0.05).After treatment,the levels of VEGF,cytokeratin 21-1 fragment(CYFRA21-1)and carcinoembryonic antigen(CEA)in the study group were lower than those in the control group:(472.93±45.71)ng/L vs.(510.26±50.49)ng/L,(4.82±1.13)μg/L vs.(5.25±1.34)μg/L,(5.65±1.24)μg/L vs.(6.17±1.42)μg/L,there were statistical differences(P<0.05).After treatment,the levels of CD_(3)^(+),CD_(4)^(+)and CD_(4)^(+)/CD 8+in the study group were higher than those in the control group,and the level of CD 8+was lower than that in the control group:0.532±0.044 vs.0.508±0.041,0.321±0.030 vs.0.305±0.027,1.02±0.19 vs.0.93±0.16,0.303±0.040 vs.0.320±0.044,there were statistical differences(P<0.05).There was no significant difference in the occurrence of adverse reactions between the two groups(P>0.05).Conclusions Anlotinib combined with radiotherapy can enhance the clinical efficacy of second-line targeted drug resistant advanced lung adenocarcinoma with EGFR mutation,improve tumor indexes,promote the recovery of immune function,without significantly increasing adverse reactions.