Abstract
The aim of this study was to explore change and significance of serum carcino-embryonic antigen (CEA) before and after gefitinib therapy in patients with advanced non-small-cell lung cancer (NSCLC). Forty patients with advanced NSCLCs in III~IV stages were selected as study objects given gefitinib therapy combined with routine local radiotherapy until tumor progression or intolerable toxicity. After treatment, all patients were divided into control and non-control groups according to the results of evaluation based on RECIST 1.1 (Response Evaluation Criteria in Solid Tumors in 2009). Peripheral fasting blood from all patients was collected in the early morning and serum CEA was assessed by electro-chemiluminescence immunoassay (ECLIA) before and after treatment. Before treatment, patients were divided into high CEA group (CEA level > 50 ng/mL) and low CEA group (CEA level ≤ 50 ng/mL). Adverse reactions were noted and progression-free survival (PFS) in both groups was recorded after long-term follow-up that ended in December, 2012. There was no difference between control and non-control groups in CEA level before treatment (P>0.05), whereas serum CEA decreased more markedly lower in the control group after treatment (P<0.01). All patients were divided into high CEA group (26) and low CEA group (14) according to serum CEA level. There was no statistically significant difference between two groups in adverse reactions (P>0.05) but the rate in former group was lower. Additionally, survival rates at 9 and 12 months in high CEA group were clearly higher than in the low CEA group (P<0.01). Serum CEA level can serve as a biochemical index to evaluate the prognosis with gefitinib treatment for NSCLC.
Highlights
Materials and MethodsLung cancer is one of the worst malignant tumors in the world, in which non-small-cell lung cancer (NSCLC) is commonly treated by conventional systematic chemotherapy (Liu et al, 2013; Lu et al, 2013)
Efficacy evaluation Therapeutic efficacy was divided into complete remission (CR), partial remission (PR), stable disease (SD) and progressive disease (PD), according to the results of head CT scan and nuclear magnetic resonance, chest and abdomen CT scan as well as bone scan, and efficacy of gefitinib was evaluated based on RECIST 1.1 Criteria in 2009
Studies of some researchers have revealed that proper expression of epidermal growth factor receptor (EGFR) in epithelium-derived tumor cells regulate cell proliferation, and has critical impact on the development of tumors, formation of vessels as well as metastasis and spreading of tumor cells, whereas over-expression of EGFR is insensitive to chemotherapy and radiotherapy, which can bring about distant metastasis and poor prognosis (Al et al, 2013; Karachaliou et al, 2013; Lopez-Rios et al, 2013)
Summary
Lung cancer is one of the worst malignant tumors in the world, in which NSCLC is commonly treated by conventional systematic chemotherapy (Liu et al, 2013; Lu et al, 2013). Studies in recent years have showed that molecular targeted therapy is favorable in treating NSCLC (Maftouh et al, 2013; Sechler et al, 2013). As one of the molecular targeted therapeutic drugs and as the epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI), gefitinib has great antitumor function in progressive and recurrent NSCLC (Lee et al, 2013; Morabito et al, 2013; Sudo et al, 2013). The purpose of this study was to explore the serum CEA level change and its significance before and after gefitinib treatment in patients with advanced NSCLC. Radiotherapy and chemotherapy over 1 week or those with sever abnormity in electrocardiogram, routine blood and hepato-renal function were excluded from the research, those enrolled were examined by transbronchial lung biopsy to diagnose pathology, and
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