熊鑫

【摘要】 目的：探讨安罗替尼胶囊联合免疫一线维持治疗在广泛期小细胞肺癌中的应用效果。方法：选取江西省胸科医院2021年12月—2022年12月收治的78例广泛期小细胞肺癌患者作为研究对象，按照随机数字表法将其分为研究组与对照组，各39例。对照组采用免疫一线维持治疗，研究组在对照组的基础上联用安罗替尼胶囊维持治疗。比较两组客观缓解率（ORR）、疾病控制率（DCR），以及治疗前后血清血管内皮生长因子（VEGF）、碱性成纤维细胞生长因子（bFGF）、安全性。结果：研究组ORR及DCR均优于对照组（P<0.05）；治疗后，研究组血清VEGF、bFGF水平均显著低于对照组（P<0.01）；两组不良反应总发生率比较，差异无统计学意义（P>0.05）。结论：安罗替尼胶囊联合免疫一线维持治疗广泛期小细胞肺癌可以提高整体效果，有效抑制肿瘤血管新生，诱导肿瘤细胞凋亡，安全性可。

【关键词】 安罗替尼胶囊 免疫治疗 一线维持治疗 广泛期小细胞肺癌

Clinical Effect of Anlotinib Capsules Combined with Immune First-line Maintenance Treatment for Extensive Stage-small Cell Lung Carcinoma/XIONG Xin. //Medical Innovation of China， 2024， 21（13）： 0-100

[Abstract] Objective： To investigate the application effect of Anlotinib Capsules combined with immune first-line maintenance treatment for extensive stage-small cell lung carcinoma. Method： A total of 78 patients with extensive stage-small cell lung carcinoma treated in Jiangxi Chest Hospital from December 2021 to December 2022 were selected as the study objects， and were divided into study group and control group according to random number table method， with 39 cases in each group. The control group was treated with immune first-line maintenance therapy， and the study group was treated with Anlotinib Capsules on the basis of the control group. Objective response rate （ORR）， disease control rate （DCR）， serum vascular endothelial growth factor （VEGF）， basic fibroblast growth factor （bFGF） before and after treatment and safety were compared between the two groups. Result： The ORR and DCR of the study group were better than those of the control group （P<0.05）. After treatment， serum VEGF and bFGF levels in the study group were significantly lower than those in the control group （P<0.01）. There was no significant difference in the total incidence of adverse reactions between the two groups （P>0.05）. Conclusion： Anlotinib Capsules combined with immune first-line maintenance treatment for extensive stage-small cell lung carcinoma can improve the overall efficacy， effectively inhibit tumor angiogenesis， induce tumor cell apoptosis， and have good safety.

[Key words] Anlotinib Capsules Immunotherapy First-line maintenance therapy Extensive stage-small cell lung carcinoma

First-author's address： Department of Oncology Ⅱ， Jiangxi Chest Hospital， Nanchang 330006， China

doi：10.3969/j.issn.1674-4985.2024.13.022

肺癌是常见恶性肿瘤，具有发病率、死亡率均高的特点。小细胞肺癌（SCLC）占全部肺癌类型的15%～20%，是恶性程度最高、分化程度最低的病理类型[1]。其中，70%的患者被归类为广泛期SCLC（extensive stage-SCLC，ES-SCLC），这给患者的生命带来了极大的威胁[2]。《中国临床肿瘤学会（CSCO）小细胞肺癌诊疗指南2022》中ES-SCLC一线治疗Ⅰ级推荐仍然是EC化疗联合免疫治疗4周期后进行免疫维持治疗，直至疾病进展或毒性不能耐受[3]。尽管SCLC最初治疗阶段具有较高敏感性，但是由于SCLC复发快、转移早等特点，总体治疗成效却受到相当程度的限制，所以找到延长维持期的有效途径就显得尤为关键。随着靶向治疗技术的进步，SCLC预后明显改善，靶向治疗药物已成为医学探讨的热点。……