沙利度胺联合GP方案治疗晚期非小细胞肺癌的临床研究

目的探讨沙利度胺联合化疗治疗晚期非小细胞肺癌的近期有效率及其对血清中VEGF、bFGF、TNF-α的影响。方法70例晚期非小细胞肺癌随机分为2组，联合组：GP＋沙利度胺治疗，共35例。化疗组：单纯使用GP方案化疗。结果联合组的治疗有效率（CR＋PR）为51．4％，化疗组有效率为34．3％，两组有效率比较，差异无统计学意义（P〉0．05）。联合组中治疗有效的患者，血清VEGF较前明显降低，差异有统计学意义（P〈0．05）；化疗组中治疗有效的患者，血清VEGF较前降低，但差异无统计学意义（P〉0．05）。两组中化疗无效的患者治疗后，血清VEGF水平均比治疗前显著升高，差异有统计学意义（P〈0．05）。联合组治疗后，血清TNF—α较前明显降低，差异有统计学意义（P〈0．05）；化疗组治疗后，血清TNF—α含量较前无明显变化（P〉0．05）。两组患者治疗前后，血清bFGF含量无明显变化（P〉0．05）。结论沙利度胺联合GP能改善晚期非小细胞肺癌患者的近期有效率；沙利度胺联合化疗可抑制肿瘤细胞VEGF的产生；沙利度胺能够抑制肿瘤细胞TNF-α的产生。

Objective To evaluate the impact of thalidomide combined with gemcitabine and cisplatin on the short - term clinical effects in patients with advanced non - small cell lung cancer, and the impact on the serum levels of VEGF, bFGF and TNF -α. Methods 70 cases with advanced NSCLC were randomly divided into 2 groups. 35patients in combined group were treated with GP chemotherapy regimen plus thalidomide, whereas 35 patients in the control group were treated with GP chemotherapy regimen alone. Results The total effective rate was 51.4% in combined group and 34. 3% in chemotherapeutic group, however, the difference between the two groups was not significant（ P 〉 0. 05 ）. The serum level of VEGF in the combined group of patients with a positive response to the treatment was decreased significantly （ P 〈 0. 05 ）, but the serum level of VEGF in patients with response in the chemotherapy group was no significant differences than before（ P 〉0.05 ）. Meanwhile, the serum level of VEGF in patients with no response in the two groups was increased significantly（ P 〈 0. 05 ）. After the treatment, the serum level of TNF -α in the combined group was remarkably decreased than before （ P 〈 0. 05 ）, but it was not changed very much in the chemotherapy group （ P 〉 0.05 ）. Similarly, the serum level of bFGF in the two groups had no significant differences （ P 〉 0. 05 ）. Conclusions The thalidomide combined with gemcitabine and cisplatin could improve the short - term clinical effective rate of patients with advanced non - small cell lung cancer, and inhibit the expression of serum VEGF and TNF - α.