重组人血管内皮抑素联合化疗治疗晚期非小细胞肺癌的效果

doi:10.3969/j.issn.1000-8535.2019.01.018

摘要/Abstract

摘要： 目的观察重组人血管内皮抑素注射液（恩度）联合化疗治非小细胞肺癌（NSCLC）的近期疗效和安全性。方法对2015年3月—2017年10月经病理组织学或细胞学检查确诊的Ⅲ-Ⅳ期NSCLC74例患者,采用随机数字法把受试者随机分为联合治疗组（n=35）和对照组（n=39）,联合治疗组接受恩度联合化疗的方案治疗;对照组单纯行常规化疗治疗。近期疗效评价采用RECIST标准,生活质量（QOL）采用Karnofsky评分（KPS）,抗癌药物急性与亚急性毒性反应分度标准分0~Ⅳ度。比较两组患者的近期疗效指标（疾病完全缓解（CR）、疾病稳定（ SD）、疾病进展（ PD）、客观有效率（RR）、疾病控制率（DCR ）;QOL评分及毒副反应情况。结果联合治疗组近期疗效指标RR及DCR高于对照组（P < 0.05）;联合治疗组KPS评分高于对照组（P < 0.05）;两组间的毒副作用包括恶心/呕吐、腹泻、疲乏、脱发、血小板下降及白细胞下降等,两组间毒副反应出现数量比较,差异无统计学意义（P > 0.05）。结论恩度与化疗药物联合使用可以提高NSCLC疗效和改善患者生活质量,未增加患者不良反应发生率。

关键词: 非小细胞肺癌, 重组人血管内皮抑素, 化疗, 近期疗效

Abstract: Objective To observe the curative effect and the side effects of recombinant human vascular endostatin （Endostar） combined with the chemotherapy on nonsmall cell lung cancer（NSCLC）. Methods Seventy-four NSCLC patients confirmed by histopathology or cytopathology were randomly distributed to combined therapy group （n=35, with Endostar combined with chemotherapy） and control group （n=39, with conventional chemotherapy）. The recent efficacy of drug was evaluated according to the RECIST criteria. The quality of life （QOL） was assessed by usingto the Karnofsky scores, and the safety of drug was evaluated according to WHO side effects criteria. Results The therapeutic effectiveness was better in the combined therapy group than that in the control group（P<0.01）. The KPS was better in co-therapy group than that in the control group（P<0.05）. The common adverse reactions in both groups included neutropenia, thrombocytopenia, nausea/vomiting, diarrhea, lassitude, alopecia, thrombocytopenia and leukocytopenia. However, the incidence rates of adverse reactions between the two group was not significant （P>0.05）. Conclusion Endostar combined with the related chemotherapy may improve the curative effect and QOL of NSCLC.

Key words: Nonsmall cell lung cancer, Rh-endostatin /Endostar, Chemotherapy, Short-term effects

肖云华, 李宝秀. 重组人血管内皮抑素联合化疗治疗晚期非小细胞肺癌的效果[J]. 广州医药, 2019, 50(1): 72-75.

XIAO Yunhua, LI Baoxiu. Curative effect of recombinant human vascular endostatin combined with chemotherapy on advanced nonsmall cell lung cancer[J]. Guangzhou Medical Journal, 2019, 50(1): 72-75.

参考文献

[1] BAO Y, PENG F, ZHOU Q C, et al.Phase Ⅱ trial of recombinant human endostatin in combination with concurrent chemoradiotherapy in patients with stage Ⅲ non-small-cell lung cancer[J]. Radiother Oncol, 2015, 114(2):161-166.
[2] 江丰收,孙玉蓓,王刚,等.重组人血管内皮抑素联合DP方案治疗晚期非小细胞肺癌67例[J]. 肿瘤研究与临床,2011,23(4):264-266.
[3] 许健,陈波,曹建民,等.重组人血管内皮抑素联合吉西他滨、顺铂方案双途径给药治疗晚期非小细胞肺癌的临床研究[J]. 临床肿瘤学杂志,2011,16(8):709-714.
[4] 蔡莉,孙立春,杨春雨,等.恩度联合化疗治疗中晚期非小细胞肺癌的疗效观察[J]. 中国实用内科杂志,2007,27(19):1541-1542.
[5] TIMMERMANN C.Just give me the best quality of life questionnaire:the Karnofsky scale and the history of quality of life measurements in cancer trials[J]. Chronic Illn, 2013,9(3):179-190.
[6] EISENHAUER E A, THERASSE P, BOGAERTS J, et al.New response evaluation criteria in solid tumours:Revised RECIST guideline (version 1.1)[J]. Eur J Cancer, 2009,45(2):228-247.
[7] 张世军,姜秋颖.恩度联合化疗治疗消化系统晚期癌症的临床研究进展[J]. 现代肿瘤医学,2017,25(13):2178-2182.
[8] 沈钰新,赵伟新,王升平,等. 重组人血管内皮抑制素单药对非小细胞肺癌肿瘤血管微环境影响的初步研究[J]. 中国癌症杂志,2015,25(10):817-822.
[9] 曲怡梅,廖国清,王红梅.等. 重组人内皮抑素联合化疗改善晚期非小细胞肺癌生活质量临床研究[J]. 中国医药导报,2011,8(32):26-28.
[10] 赵柏林,戈伟,郑永法. 恩度联合同步放化疗治疗局部晚期非小细胞肺癌的临床效果[J]. 中国医药导报,2016,13(14):84-87.
[11] 罗兴洪,赵岩,钱海波. 重组人血管内皮抑制素治疗肺癌的研究进展[J]. 中国新药杂志,2014,23(13):1525-1530.
[12] JOU E,RAJDEV L.Current and emerging therapies in unresectable and recurrent gastric cancer[J]. World J Gastroenterol,2016,22( 20):4812-4823.
[13] 戴文鑫,吴智勇,陈娟,等.重组人血管内皮抑制素在晚期非小细胞肺癌治疗中的效果观察[J]. 检验医学与临床,2015,12(10):1452-1454.
[14] YU Z W, JU Y H, YANG C L, et al.Antitumor effect of recombinant human endostatin combined with cisplatin on rats with transplanted Lewis lung cancer[J]. Asian Pac J Trop Med,2015 ,8(8):664-667.
[15] DENG WY,SONG T,LI N,et al.Clinical observation and therapeutic evaluation of rh-endostatin combined with dp regimen in treating patients with advanced esophageal cancer[J]. Asian Pac J Cancer Prev,2014,15(16):6565-6570.
[16] 陈群,石琴,谢强.恩度同步放疗治疗不能手术局部晚期老年非小细胞肺癌的临床疗效[J]. 中国癌症防治杂志,2017,9(4):142-145.