恩度联合化疗治疗晚期复治非小细胞肺癌31例的临床探讨

Combining rh-endostatin with Chemotherapy for Second Line Treatment of Advanced Non-small-cell Lung Cancer

目的:观察重组人血管内皮抑制素恩度治疗复治的晚期非小细胞肺癌的疗效和安全性。方法:2006年7月至2008年3月本院31例经病理证实的符合入选标准的复治非小细胞肺癌患者,接受恩度联合化疗治疗方案。化疗2个周期后按照WHO标准和中位肿瘤进展时间、中位生存期和1年生存率评价疗效,按照NCI CTC 3.0版标准评价毒性反应。用药1周期评价毒性反应,2周期后评价疗效。结果:31例患者26例完成2个周期以上化疗,可评价疗效的患者25例。其中PR 5例,SD 15例,PD 5例,客观有效率(RR)20%(5/25),疾病控制率为80%(20/25);中位疾病进展时间(mTTP)136±28天,中位生存期(MST)294±14天,1年生存率33.3%。毒性反应以骨髓抑制和胃肠道反应发生率较高,多为Ⅰ～Ⅱ度,Ⅲ～Ⅳ度少见,考虑可能和化疗有关。结论:恩度联合化疗对多程化疗后复发的非小细胞肺癌显示出一定的抗肿瘤活性,安全性较好,临床受益率高,是一种有临床应用前景的局部姑息性治疗方法。

Objective： To observe the efficacy and safety of a combination of chemotherapy and rh-endostatin （endostar） for second line treatment of advanced non-small-cell lung cancer （NSCLC）. Methods： From July 2006 to March 2008, 31 advanced NSCLC cases confirmed by pathology received rh-endostatin and chemotherapy in a second attempt at treatment. The efficacy was strictly evaluated after 2 cycles according to WHO criteria, median survival time, the median time to progression, and the 1-year survival rate. Safety was evaluated after 1 cycle according to NCI CTC 3.0 version criteria. Results： Safety evaluation was performed in all 31 cases. Twenty-five cases were evaluable for efficacy. Of the 25 cases, 5 had PR, 15 had SD, and 5 had PD. The objective response rate （RR） was 20% （5/25） and the disease control rate （DCR） was 80% （20/25）. The median survival time and the median time to progression were 294 days and 136 days, respectively. The 1-year survival rate was 33.3%. Major toxicities included neutropenia, anaemia and gastrointestinal symptoms, which were mainly correlated with the chemotherapy regimen. Conclusion： rh-endostatin in combination with chemotherapy had anti-tumor activity with a high disease control rate in patients with advanced NSCLC. This combination treatment can be tolerated and may be a promising regimen as a second-line therapy for advanced NSCLC.