血管内皮抑素联合吉西他滨和顺铂治疗晚期非小细胞肺癌的临床观察

Study of feasibility of endostar plus gemcitabine and cisplatin regimen for advanced non-small cell lung cancer

目的:观察抗血管生成的内皮抑素-恩度联合吉西他滨+顺铂方案一线治疗晚期非小细胞肺癌的疗效及毒副反应。方法:回顾性分析2006-01-2008-04收治的85例晚期非小细胞肺癌患者的临床资料,其中吉西他滨+顺铂(GP)方案治疗55例,恩度+吉西他滨+顺铂(GPE)方案治疗30例。以完全缓解、部分缓解、稳定和病情进展为近期疗效评价指标;远期疗效评价指标包括无进展生存时间、中位生存期和1年生存率。评价血液学毒性、消化道反应和心脏毒性等毒副反应。结果:GP方案组与GPE方案组的总有效率分别为30.9%和53.3%,差异有统计学意义,P<0.05;无进展生存时间分别为5.8个月和6.9个月,中位生存期和1年生存率相似,差异无统计学意义,P>0.05。两组患者的Ⅲ～Ⅳ度中性粒细胞减少和血小板减少发生率、恶心呕吐发生率,差异无统计学意义,P>0.05,但心率失常发生率GP方案组(4.0%)较GPE方案组(9.5%)低,差异有统计学意义,P<0.05。结论:GP方案加用恩度可以提高治疗晚期NSCLC的有效率,延长无疾病进展时间,其毒性可以耐受,但远期疗效有待于进一步观察。

OBJECTIVE：To investigate the efficacy and safety of endostar plus gemcitabine and cisplatin regimen for advanced non-small cell lung cancer（NSCLC）.METHODS：The clinical data of 85 cases of advanced NSCLC from Jan.2006 to Apr.2008 were analyzed retrospectively.Fifty cases of them were treated by gemcitabine and cisplatin（GP）regimen,30 cases of them were treated by endostar plus gemcitabine and cisplatin（GE）regimen.The complete remission,partial remission,and stable disease were evaluated for the short-term efficacy.Long-term efficacy evaluation included progression-free survival,median survival time and 1-year survival rate.The hematological toxicity,gastrointestinal reactions and cardiac toxicity were evaluated.RESULTS：The overall response rates were 30.9% and 53.3% in GP group and GPE group respectively.There was a significant difference（P〈0.05）,but the progression-free survival,median survival time and 1-year survival rate were similar（P〈0.05）.Ⅲ-Ⅳdegree toxicities of neutropenia,thrombocytopenia,nausea and vomiting were not significantly differenct between the two groups（P〈0.05）.The incidence of arrhythmia in GP group（4.0%）was lower than that in GPE group（9.5%,P〈0.05）.CONCLUSIONS：Endostar plus GP regimen can improve the short-term efficacy for advanced NSCLC.Its toxicity can be tolerated,but long-term effects should be further observed.