氩氦刀冷冻消融序贯重组人血管内皮抑制素治疗晚期复治非小细胞肺癌的临床研究

A clinical study of Ar-He cryoablation combined with recombinant human endostatin in treatment of advanced refractory non-small cell lung cancer patients

目的探讨氩氦刀冷冻消融序贯重组人血管内皮抑制素注射液(商品名为恩度,以下简称恩度)治疗复治的晚期非小细胞肺癌的临床疗效。方法 30例化、放疗无效的Ⅲ和Ⅳ期非小细胞肺癌患者分为两组:一组18例接受经皮穿刺氩氦刀冷冻消融联合恩度治疗;另一组12例单纯行氩氦刀冷冻消融治疗。以胸部CT动态观察治疗前后的变化,随访患者生存时间。结果治疗结束后1个月CT复查:两组患者的临床受益率基本一致。而术后3个月及6个月CT复查后进行疗效评价则显示:氩氦刀联合恩度治疗组临床受益率明显优于单纯氩氦刀治疗组。远期生存分析:氩氦刀联合恩度治疗组中位生存时间为279 d,单纯氩氦刀治疗组的中位生存时间为258 d,前者中位生存期明显延长(P<0.01)。结论氩氦刀联合恩度治疗晚期复治非小细胞肺癌有较好的临床疗效。

Objective To investigate the clinical efficacy of Ar-He cryoablation combined with recombinant human endostatin in treatment of advanced refractory non-small cell lung cancer.Methods Thirty stage Ⅲ and stage Ⅳ refractory non-small cell lung cancer patients were randomly divided into two groups.One group included eighteen patients who received recombinant human endostatin therapy one week after cryoablation.The other group consisted of twelve patients that received Ar-He cryoablation alone.The CT scan of the chest and survival time was followed up after the treatment.Results The clinical response rate was found to be pretty much the same one month after treatment in the two groups,but was significantly higher in the cryoablation＋endorstar group than in the cryoablation group three months and six months after treatment.The median survival time was 279 days in the cryoablation ＋ endorstar group and 258 days in the cryoablation group;the difference was significant between the two groups（P0.01）.Conclusions Better clinical efficacy can be achieved in treating advanced refractory non-small cell lung by cryoablation combined with recombinant human endostatin.