沙利度胺与NP方案联合治疗晚期非小细胞肺癌的疗效观察

The effect study of thalidomide combined with NP regimen for advanced non-small cell lung cancer

目的观察沙利度胺联合NP方案对晚期非小细胞肺癌(NSCLC)治疗前后外周血中血管内皮生长因子(VEGF)的变化及不良反应。方法将经病理学或细胞学确诊的Ⅲ_B、Ⅳ期NSCLC患者56例,随机分为治疗组30例和对照组26例。治疗组采用NP方案+沙利度胺治疗(长春瑞滨25 mg/m^2静脉滴注,第1、8天;顺铂80 mg/m^2静脉滴注,第1天;沙利度胺200 mg口服,第1天起连续给药);对照组采用NP方案化疗(剂量、方法与治疗组相同)。治疗2个周期后观察临床疗效,并采用酶联免疫吸附试验(ELISA)检测VEGF水平。结果治疗组和对照组的有效率分别为53.3%和38.5%,差异无统计学意义(P>0.05),治疗组中治疗有效的患者,血清VEGF较治疗前明显降低,差异有统计学意义(P<0.05);对照组中治疗有效的患者,血清VEGF较治疗前下降不明显,差异无统计学意义(P>0.05);治疗组和对照组间不良反应发生率比较,差异无统计学意义(P>0.05)。结论沙利度胺与NP方案联合应用有提高晚期NSCLC患者近期疗效的趋势,并降低血清VEGF水平,且不增加治疗后不良反应的发生率。

Objective To observe the efficacy and toxicity in the patients with advanced non-small cell lung cancer（NSCLC）,treated with thalidomide plus vinorelbine and cisplatin（NP）or NP alone.To evaluate the change of VEGF in peripheral blood in patients with advanced NSCLC.Methods 56 patients with advanced NSCLC were di- vided randomly into trial group（n=30）and control group（n=26）,The trial group was treated with vinorelbine 25mg/m^2 iv,on d_1 and d_8,cisplatin 80 mg/m^2 iv on d_1,and thalidomide 200 mg orally and daily from d_1.The contral group received vinorelbine and cisplatin as above described.The VEGF was measured by ELISA.Results The overall response rate was 53.3%in the trial group and 38.5%in the control group,there were no significant differences between the two groups（P0.05）.Patients in benefit in trial group had a remarkable decrease in the number of VEGF（P0.05）while patients in benefit in control group had little decrease in the number of VEGF（P0.05）. there were no significant differences in toxicities between the two groups（P0.05）.Conclusion Thalidomide combined with NP regimen can enhance curative effect in the near future and decrease the leval of VEGF in serum without increased toxicities.