重组人血管内皮抑制素联合NP或GP方案治疗晚期非小细胞肺癌临床观察

Clincal observation of Endostar combined with NP or GP regimen in advanced non-small cell lung cancer patients

目的观察重组人血管内皮抑制素(恩度)联合NP及GP方案治疗晚期非小细胞肺癌(NSCLC)的疗效和毒副反应。方法经病理学检查证实的68例ⅢB期和Ⅳ期NSCLC患者,包括鳞癌24例,腺癌32例,其他类型12例,均采用恩度加化疗联合治疗,其中联合NP方案41例,联合GP方案27例。恩度剂量为15 mg/次,加入生理盐水500 ml中静滴3～4 h,第1～14天;NP方案为长春瑞滨25 mg/m2静滴第1、5天,顺铂25mg/m2静滴第2～4天;GP方案为吉西他滨1000 mg/m2静滴第1、8天,顺铂25 mg/m2静滴第2～4天,均21 d为1个周期。所有患者至少完成2个周期,观察其近期疗效及毒副反应。结果 68例晚期NSCLC患者中,获得CR 1例,PR 26例(38.2%),SD 24例(35.2%),PD 17例(25.0%),总有效率为39.7%,临床受益率75.0%。发生Ⅲ～Ⅳ度中性粒细胞减少20例(29.4%),Ⅲ～Ⅳ度血小板减少8例(11.7%),Ⅲ～Ⅳ度呕吐15例(22.0%),全组无心律失常和出血发生。结论恩度联合NP及GP方案化疗治疗晚期NSCLC近期客观疗效较高,安全性好。

Objective To observe the efficacy and safety of rh-endostatin injection（endostar） combined with NP or GP regimen in patients with advanced non-small cell lung cancer（NSCLC）. Methods 68 histologically confirmed stage ⅢB and Ⅳ NSCLC patients, including 24 cases with squamous cell carcinoma, 32 cases with adenocarcinoma and other 12cases. There were 41 patients administrated with en-dostar puls NP regimen and 27 patients administrated with endostar puls GP regimen, endostarl5 mg solved in 500 ml of normal saline was slowly dropped from day 1 to ld, NVB 25 mg/m2 iv day 1, 5, gemcitabine 1000 mg/m^2 iv day 1, 8, cisplatin 25 mg/m^2 iv day 2 to 4, repeated 21 days. All patients shoud completed 2 cycles at least. Observe the therapeutic effects and adverse reactions. Results Among 68 cases, there were 1 case CR, 26 cases PR（38.2% ） 24 cases SD（35.2% ） and 17 cases PD（25.0% ）. Overall response ratewas39. 7% and clinical benefit rate 75.0%. The ⅢI -Ⅳ toxicities including neutropenia 20 caces （29. 4% ）, thrombocytopenia 8 cases（ 11.7% ）, vomiting 15 cases（22. 0% ）. Arrhythmia and hemorrhage had no occurenced. Conclusion Endostar combined NP or GP regimen were effective and safe intreatment of advanced NSCLC.