| Objective:Objective to analyze and observe the clinical efficacy,adverse reactions and related factors of third-line treatment of advanced non-small cell lung cancer with anlotinib.Methods:In this study,we analyzed 41 patients with advanced non-small cell lung cancer(NSCLC)diagnosed by histology in Affiliated Hospital of Yangzhou University.The clinical data were statistically analyzed by SPSS 26.0 software,and the changes of coagulation function and tumor markers before and after two cycles of treatment were analyzed.The survival rate was estimated by Kaplan Meier method,and the survival curve was drawn.Test level α=0.05(bilateral).Results:1.Analysis results of coagulation function index:(1)There were significant differences between gender,ECOG score,clinical stage,pathological type and coagulation function indexes(P<0.05);FIB in male patients was significantly higher than that in female patients(P<0.05);FIB and D-D in patients with ECOG score 2 were significantly higher than those in patients with ECOG score 0-1(P<0.05);FIB in patients with stage Ⅳ was significantly higher than that in patients with stage III(P<0.05);FIB,D-D and PLT in patients with adenocarcinoma were significantly higher than those in patients with squamous cell carcinoma(P<0.05);There was no significant difference in age,smoking and coagulation function(P>0.05).(2)After treatment,FIB,D-D and PLT levels were lower than those before treatment(P<0.05).2.Analysis results of tumor markers:(1)There were significant differences between ECOG score,pathological type and tumor markers(P<0.05);the CEA level of patients with ECOG score 2 was significantly higher than that of patients with ECOG score 0-1(P<0.05);the CEA level of patients with adenocarcinoma was significantly higher than that of patients with squamous cell carcinoma,and the SCC level was significantly lower than that of patients with squamous cell carcinoma(P<0.05);there was no significant difference between gender,age,smoking and clinical stage and tumor markers(P>0.05).(2)After treatment,the level of CEA was significantly lower than that before treatment(P<0.05).3.Correlation analysis results:CEA level was positively correlated with FIB level(r=0.433,P=0.005);there was no correlation between other tumor markers and coagulation function indexes(P>0.05).4.In terms of objective efficacy,complete response was not seen(0/0),partial response was 4.88%(2/41),disease stability was 48.78%(22/41),disease progression was 41.46%(17/41),objective response rate was 4.88%,disease control rate was 58.53%,and median progression free survival was 3.98 months.The common adverse reactions were fatigue in 10 cases(25.6%),hypertension in 10 cases(25.6%),nausea and vomiting in 8 cases(20.5%),weight loss in 8 cases(20.5%),proteinuria in 6 cases(15.4%)and hand foot syndrome in 5 cases(12.8%).Among them,the incidence of grade 2 adverse reactions was 23.08%,and the incidence of grade 3 adverse reactions was 10.26%.No grade 4 adverse reactions occurred.The adverse reactions occurred during the treatment were improved after symptomatic treatment.No treatment-related death occurred during the follow-up.5.The analysis results of DCR:(1)DCR in ECOG score had significant difference(P<0.05),ECOG score 0-1 was better than ECOG score 2;(2)DCR in FIB,D-D had significant difference(P<0.05),FIB low group,D-D low group had better effect;(3)DCR in tumor markers had no significant difference(P>0.05).6.The results of survival analysis:(1)the median PFS of patients with ECOG score 2 was significantly shorter than that of patients 0-1,and the prognosis was poorer(P<0.05);(2)the prognosis of patients in the higher FIB group was poorer before treatment(P<0.05),the remaining indexes were not statistically significant(P>0.05);the prognosis of the FIB reduction group was better than that of the elevated group and the normal group(P<0.05);(3)the survival rate was not statistically significant among tumor markers(P>0.05).Conclusion:In the treatment of advanced NSCLC,anotinib has achieved good clinical effect,alleviated the clinical symptoms to a certain extent,and the tolerance of adverse reactions is controllable.There is a positive correlation between tumor markers and coagulation function indicators.The combined monitoring of tumor markers and coagulation function indicators can be used as monitoring indicators in the treatment of advanced non-small cell lung cancer with anlotinib,which has certain clinical significance. |
