重组人血管内皮抑制素联合治疗30例晚期非小细胞肺癌的临床研究

Clinical observation of chemotherapy combined endostar in advanced non-small cell lung cancer

目的:研究抗肿瘤新生血管生成抑制剂重组人血管内皮抑制素(恩度)联合治疗晚期非小细胞肺癌的临床疗效和毒性反应。方法:30例非小细胞肺癌均为ⅢB～Ⅳ期患者,初治或复治,采用化疗等联合恩度治疗,化疗采用常规方案,恩度15mg/次,每日1次,连续14天,每月重复使用。30例病理类型为:腺癌22例,鳞癌2例,其它类型6例;恩度联合一线化疗者5例,恩度联合二线化疗者15例,恩度联合三线及以上治疗者10例。结果:全组30例有效率(CR+PR)为26.6%,临床受益率(CBR)为79.9%;中位TTP3.6个月。使用恩度1个疗程有8例,中位生存期2.5个月;2～3个疗程14例,中位生存期3个月;4～5个疗程6例,中位生存期5.5个月;≥6个疗程2例,中位生存期9个月。毒副反应主要为食欲不振,疲乏,轻度的心脏毒副反应,包括心悸、胸闷、早搏等。其他为化疗相关的毒副反应如骨髓抑制和Ⅰ～Ⅱ度的胃肠道及外周神经毒性。结论:恩度联合化疗安全有效,耐受性好,毒副反应以Ⅰ～Ⅱ度为主,初治与复治均有效果,有效患者长期使用获益更大。

Objective ：The treatment of non-cell lung cancer （NSCLC） had firmly progressed in recently years. The research discovered the close correlation between growth, infiltrates with the metastasis and the angiogenesis in tumor. Target therapy of angiogenesis already obtained improvement survival and became new strategy in advanced non-small cell lung cancer. This article summarized the result of containing YH-16 regimens in 30 patients with NSCLC, Initially appraises the clinical response, time to progress （TTP）, the quality of life and toxicity. Methods：Thirty patients with stage ⅢB-Ⅳ non-small cell lung cancer,chemo-naive or relapse, after chemotherapy endostar 15mg/day, dayl-14 every cycle. Pathology type： adenocarcinoma 22 cases, squamous 2 cases, other 6 cases, first line treatment for YH-16 5 cases, second line 15 cases, more than third line treatment 10 cases. Results： Patients with non-small cell lung cancer received total 75 cycles chemotherapy, the average chemotherapy was 3.2 cycles. Response rate（ CR ＋ PR） was 26. 6% , clinic benefit rate was 79. 9% ,treatment group median time to progress survival time TIP was 3.6 month, 8 patients received one cycle treatment, median survival time was 2.5 months, 14 patients received two-three cycles endostar treatment, median survival time was 3 months. 6 patients received four-five cycles endostar treatment, median survival time was 5.5 months, 6 patients received six or more cycles endostar treatment, median survival time was 9 months. Only grade Ⅰ/Ⅱ toxicities were observed at this combination. Conclusion： Endostar combined chemotherapy was safe and well tolerated. Main toxicity is grade Ⅰ/Ⅱ. It has benefit for first and second line combine treatment of non-small cell lung cancer. Patients have survival benefits who response for the chemotherapy.