恩度联合GP方案治疗晩期非小细胞肺癌的疗效观察

The clinical observation of nonsmall-cell lung cancer treated by blood vessel endostatin combinded with gemcitabine and platinol

目的:观察重组人血管内皮抑制素(恩度)联合GP方案治疗晚期非小细胞肺癌(NSCLC)的疗效和毒副反应。方法:经病理学检查确诊的38例ⅢB期和ⅠV期的NSCLC患者,包括鳞癌15例,腺癌21例,腺磷癌2例,均采用恩度加GP方案化疗。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天连续给药。GP方案为吉西他滨(GEM)1 000 mg/m2第1、8天,DDP 25mg/m2第1～3天给药,所有患者至少完成2个周期。根据WHO疗效评定及毒副反应分级标准,观察近期疗效、1年生存率、疾病进展时间及毒副反应。结果:38例NSCLC患者中,获得CR1例(2.63%),PR16例(42.1%),SD11例(28.9%),PD10例(26.37%)。中位TTP为4.3个月,1年生存率为15/38(39.5%)。治疗毒副反应主要有白细胞减少、血小板减少、恶心呕吐、肌肉关节疼痛和心血管毒性等。结论:恩度联合GP方案治疗晚期NSCLC的近期客观疗效较高,且安全性较好。

Objective： To observe the curative effect and adverse reactions of nonsmall-cell lung cancer treated by blood vessel endostatin combinded with gemcitabine and platinol. Methods ：38 cases suffered from IIIB stage or IV stage nons- mall-cell lung cancer（NSCLC） confirmed by pathology received blood vessel endostatin combinded with gemcitabine and platinol chemotherapy, including 15 cases squamous carcinoma,21 cases adenocarcinoma and 2 squamous-adenocarcino- ma. The blood vessel endostatin dose was 15 mg/day intravenousdrip trough saline about 3 to 4 hours till two weeks. The gemcitabine dose was 1 000 mg/m2 intravenousdrip at the first day and the eighth day, the platinol dose was 25 mg/m2 intravenousdrip at the first, second and third day. All the patients received 2 chemotherapy cycles. The curative effects, one year survival rate, progression of disease and adverse reactions were observed according to the WHO evaluation and grade standard. Result：In all cases, one （2.63%） patient was complete remission, 16 （42.1% ） patients were partial remission, 11 （28.9%） patients were stabilization of disease and 10 （26.37%） patients were progression of disease. The mean live time was 4.3 months. One year survival rate was 39.5%. The adverse reactions including aleucocytosis, thrombocytopenia, nausea and vomiting, muscle arthrosis pain and cadiavascular toxicity. Conclusions：The curative effect of nonsmall-cell lung cancer treated by blood vessel endostatin combined with gemcitabine was well in the near fu- ture and the safety was also high.