血管内皮抑素联合影像引导放疗治疗非小细胞肺癌脑转移患者的效果

Endostar combined with image guided radiation therapy in treatment of non-small-cell lung cancer patients with brain metastasis

目的:观察血管内皮抑素(rh-endostain,商品名恩度)联合影像引导放射治疗(image guided radiation therapy,IG-RT)对非小细胞肺癌(non-small-cell lung cancer,NSCLC)脑转移患者的近期疗效和毒性反应。方法:收集河北省人民医院肿瘤科自2008年1月至6月确诊的非小细胞肺癌脑转移患者40例,随机分为两组:试验组(恩度+IGRT组)22例,采用恩度联合IGRT治疗;对照组(IGRT组)18例,采用单纯IGRT治疗。按照RESICT标准评价近期疗效,按照NCICTC3.0版标准评价毒性反应。结果:恩度+IGRT组和IGRT组NSCLC脑转移患者总有效率(CR+PR)分别为77.3%和61.1%(P<0.05),临床受益率(CR+PR+SD)分别为90.9%和72.2%(P<0.05)。所有患者毒性反应主要为白细胞减少、恶心、呕吐和乏力,两组间比较差异无统计学意义(P>0.05)。恩度+IGRT组和IGRT组患者中位无进展时间分别为11.6个月和11.3个月,1年生存率分别为54.5%和55.6%,差异均无统计学意义(P>0.05)。结论:恩度联合IGRT治疗NSCLC脑转移患者能够提高患者总有效率和临床受益率。

Objective：To observe the short-term efficacy and toxicity of Endostar combined with image guided radiation therapy （IGRT） in treatment of non-small-cell lung cancer （NSCLC） patients with brain metastasis.Methods：Forty NSCLC patients with brain metastasis,who were treated in the Department of Oncology of Provincial Hospital of Hebei during Jan.2008 to Jun.2008,were enrolled in the present study,and were randomly divided into trial group （22 cases） and control group （18 cases）.The trial group received Endostar combined with IGRT （Endostar＋IGRT group） and the control group received only IGRT at the same dosage （IGRT group）.The short-term efficacy was evaluated by RESICT criteria and toxicity was evaluated according to NCI CTC Version 3.0 criteria.Results： The overall response rate was 77.3% in Endostar＋IGRT group versus 61.1% in IGRT group （P0.05）.The clinical benefit rates in the Endostar＋IGRT group and IGRT group were 90.9% and 72.2%,respectively （P0.05）.The main toxicities were leucopenia,nausea/vomiting and acratia,and their incidences in Endostar＋IGRT group were similar to those in IGRT group （P0.05）.The median free time to progression was 11.6 months in the Endostar＋IGRT group and 11.3 months in the IGRT group （P0.05）; the one year survival rates were 54.5% and 55.6%,respectively,with no difference between the two groups （P0.05）.Conclusion： Endostar combined with IGRT can increase the total effective rate and clinical benefit of NSCLC patients with brain metastasis.