重组人血管内皮抑制素联合化疗对难治性晚期肺外恶性肿瘤的研究

Endostar Combined with Chemotherapy for Multiple Kinds of Advanced Malignancies Except Lung Cancer

目的观察重组人血管内皮抑制素联合化疗治疗难治性晚期肺外恶性肿瘤的疗效和不良反应。方法对24例Ⅲ～Ⅳ期肺外恶性肿瘤患者采用重组人血管内皮抑制素联合化疗的方法,按照RECIST标准每2个周期后评价疗效和进行生活质量评分,按照NCI CTC 3.0每周期后评价毒性。结果 24例患者可以评价客观疗效及进行不良反应评价。PR 4例,SD 16例,PD 4例,RR 16.7%(4/24),DCR 83.3%(20/24);生活质量改善8例(33.3%,8/24),稳定11例(45.8%,11/24),5例下降(20.8%,5/24)。3/4级不良反应包括白细胞下降5例(20.8%),血小板下降3例(12.5%),恶心、呕吐9例(37.5%)。另外有3例(12.5%)心电图T波、ST-T改变。结论重组人血管内皮抑制素与化疗联合应用,能改善和稳定多种难治性晚期恶性肿瘤患者的生存和生活质量,不良反应可以耐受,值得临床进一步深入观察。

Objective To observe the efficacy and toxicity of endostatin injection（YH-16,Endostar） combined with chemotherapy for multiple kinds of advanced malignancies except lung cancer.Methods Endostar combined with chemotherapy were administrated to 24 malignant cases of stage Ⅲ～Ⅳmultiple kinds of advanced malignancies except lung cancer confirmed by histopathology or cytopathology.The efficacy and quality of life were evaluated strictly every 2 cycles according to RECIST criteria.Toxicity was evaluated every cycle according to NCI CTC 3.0 version of criteria.Results 24 cases were evaluable for efficacy and toxicity.Among 24 evaluable cases,there were 4 cases of PR,16 cases of SD,and 4 cases of PD.The objective response rate（RR） was 16.7%（4/24）,the disease control rate（DCR） was 83.3%（20 /24）.The quality of life（QOL） were improved on 8 cases（33.3%,8/24）,stabled on 11 cases（45.8%）,and decreased on 5 cases（20.8%）.3 /4 toxicities including neutropenia（5/24,20.8%）,thrombocytopenia（3/24,12.5%）,nausea /vomiting（9/24,37.5%）.Conclusion The survial and QOL of patients with multiple kinds of advanced malignancies may be improved by endostar combined with the related chemotherapy.It is well tolerated and worthy of further clinical observation.