Observation of the clinical effect of different doses of gemcitabine chemotherapy for patients with high expression of human equilibrative nucleoside transporter 1 after advanced non-small-cell lung cancer operation

Lou Jun; Sheng Yu; Ling Jin; Yuan Xiamei; Wu Minli; Tang Wanfen

doi:10.3760/cma.j.issn.1673-4777.2015.01.003

Abstract：Objective To observe the clinical effect of different doses of gemcitabine chemotherapy for patients with high expression of human equilibrative nucleoside transporter 1 (hENT1) after advanced non-smallcell lung cancer(NSCLC) operation.Methods Advanced NSCLC patients were selected in our hospital from July 2008 to December 2013,and advanced NSCLC with pathological diagnosis after operation,making the tumor tissue into paraffin block specimens,testing the expression level of hENT1 antibody by immunohistochemical SP method.62 cases with high expression of hENT1 were divided into two groups by the completely random digit grouping method,the control group were given chemotherapy with routine dose of gemcitabine combined with cisplatin,the observation group were given chemotherapy with low dose gemcitabine combined with cisplatin,the quality of life,curative effect and toxic and side reaction were observed in the two groups after chemotherapy.Results The shortterm effective rate and the disease control rate had no significant differences between the observation group and the control group[46.9％ (15/32) vs 43.3％ (13/30),81.2％ (26/32) vs 76.9％ (23/30)] (x2 =0.08,x2 =0.20,all P ＞ 0.05) ; the Ⅲ,Ⅳ side effects were compared between two groups after chemotherapy,the observation group was better than the control group in leukopenia,thrombocytopenia,nausea,vomiting,and there is a statistically significant difference(P ＜0.05) ; the quality life was compared between two groups after chemotherapy with quality of life questionnaire core scale QLQ-C30 and lung cancer specific scale QLQ-LC13.Except role function,the total score of quality of life,physical function,emotional function,cognitive function,social function and economic conditions in the observation group were better than those in the control group [(54 ± 20)scores vs (54 ± 16) scores,(72 ± 25) scores vs (62 ± 20) scores,(85 ± 20) scores vs (72 ± 19) scores,(76 ± 28) scores vs (62 ± 25) scores,(61 ± 24) scores vs (49 ± 30) scores,(36 ± 24) scores vs (56 ± 21) scores],the difference was statistically significant(P ＜ 0.05).The other symptom scores of observation group were better than the control group except fatigue (P ＜ 0.05).Conclusion While maintaining the equal chemotherapy effect compared with routine dose of gemcitabine and for patients with high expression of hENT1 after advanced NSCLC operation,using low dose gemcitabine can effectively reduce the toxic side reaction and improve the patients' quality life in chemotherapy process.