Azithromycin enhances the favorable results of paclitaxel and cisplatin in patients with advanced non-small cell lung cancer
Azithromycin enhances the favorable results of paclitaxel and cisplatin in patients with advanced non-small cell lung cancer
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DOI：
10.4238/2014.april.14.8
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发表时间：
2014-01-01
影响因子：
0.4
通讯作者：
Yu, Z. Y.
中科院分区：
文献类型：
--
作者：
Chu, D. J.;Yao, D. E.;Yu, Z. Y.
尽管新的化疗药物不断被应用，但其对非小细胞肺癌（NSCLC）的疗效仍不令人满意。近年来，流行病学调查表明，慢性肺炎衣原体（Cpn）感染可能诱发肺癌，因为稳定的高滴度Cpn抗体，特别是IgA，是慢性感染的标志。阿奇霉素通常用于治疗Cpn感染；然而，关于阿奇霉素(A)联合紫杉醇、顺铂（TP）治疗晚期NSCLC的报道很少。考虑到NSCLC患者Cpn感染率较高，我们建议在晚期NSCLC化疗中应用阿奇霉素治疗Cpn感染。本研究的目的是探讨阿奇霉素对非小细胞肺癌化疗的影响。86例III-IV期NSCLC患者随机分为TP组和ATP组；两组患者的特征无显著差异。TP组采用紫杉醇联合顺铂治疗，ATP组采用阿奇霉素联合TP治疗至少4周，评估比较两组化疗前后的疗效、副作用及患者生活质量。Cpn感染检测显示，ATP组治疗前后病例数与TP组比较差异有统计学意义（P < 0.01），治疗后ATP组与TP组比较差异有统计学意义（P < 0.01）。两种化疗方案后患者生活质量的变化均有统计学意义（P < 0.05），但治疗后仅认知功能差异有统计学意义。两种化疗方案后患者的症状评分变化均有统计学意义（P < 0.05），但治疗后仅呼吸短促、咳嗽两项差异有统计学意义。采用Kaplan-Meier估计描述两组患者的生存功能。TP组和ATP组的中位生存时间分别为12.0个月和13.0个月。TP组和ATP组的1年生存率分别为45.0%和75.0%，差异有统计学意义（P < 0.05）。我们对阿奇霉素+紫杉醇+顺铂治疗III-IV期NSCLC患者的研究在副作用和总生存期方面取得了良好的结果。
Although new chemotherapeutic drugs have been applied constantly, their efficacy for non-small cell lung cancer (NSCLC) is still not satisfactory. In recent years, epidemiological investigations have shown that lung cancer may be induced by chronic Chlamydia pneumoniae (Cpn) infection, since stable high titers of Cpn antibodies, especially IgA, are a hallmark of chronic infections. Azithromycin is commonly used for the treatment of Cpn infections; however, there are only few reports regarding the application of azithromycin (A) combined with paclitaxel and cisplatin (TP) for advanced NSCLC. Considering that patients with NSCLC have a higher rate of Cpn infection, we proposed to employ azithromycin for Cpn infection in chemotherapy for advanced NSCLC. The aim of this study was to explore the effects of azithromycin on chemotherapy for NSCLC. A total of 86 patients with stage III-IV NSCLC were randomly divided into TP and ATP groups; the characteristics of patients in the two groups showed no significant differences. The TP group was treated with paclitaxel and cisplatin, and the ATP group was treated with azithromycin combined with TP for at least 4 weeks, followed by evaluation and comparison of efficacy, side effects and patients' quality of life before and after chemotherapy between the two groups. Testing for Cpn infection revealed a significant difference in the case number before and after therapy in the ATP group (P < 0.01) compared with the TP group (P > 0.05), and a statistical difference was observed (P < 0.01) between the ATP and TP groups after treatment. The changes in quality of life of patients after two different chemotherapy regimens were statistically significant (P < 0.05), but there was a significant difference in only cognitive function after treatment. The changes in symptom scores of patients after the two different chemotherapy regimens were statistically significant (P < 0.05), but there was a significant difference in only shortness of breath and cough after treatment. Kaplan-Meier estimate was utilized to describe the survival function of patients in the two groups. The median survival time was 12.0 months for the TP group and 13.0 months for the ATP group. One-year survival rates of the TP and ATP groups were 45.0 and 75.0%, respectively, which were significantly different (P < 0.05). Our study of azithromycin+ paclitaxel+cisplatin on stage III-IV NSCLC patients achieved favorable results in terms of side effects and overall survival.