含铂两药方案联合贝伐珠单抗一线治疗非鳞型非小细胞肺癌的临床观察

First-line Chemotherapy with Platinum-based Two-drug Regimens and Bevacizumab for Advanced Non-squamous Non-small Cell Lung Cancer

目的观察含铂两药方案联合贝伐珠单抗一线治疗非鳞型非小细胞肺癌(non-small cell lung cancer,NSCLC)的近期疗效和远期疗效,评价贝伐珠单抗临床应用的安全性。方法对16例非鳞型NSCLC患者采用含铂两药方案联合贝伐珠单抗治疗,6个周期后评价近期疗效并随访,观察患者的无疾病进展生存期(progression-free survival,PFS)和总生存期(overall survival,OS)。化疗过程中,记录患者的毒副作用。结果 16例患者均完成6个周期的治疗,近期疗效为完全缓解(complete remission,CR)1例(6.3%),部分缓解(partial remission,PR)7例(43.8%),稳定(stable disease,SD)5例(31.2%),疾病进展(progressive disease,PD)3例(18.7%);客观有效率(objective response rate,ORR)50.0%(8/16);疾病控制率(disease control rate,DCR)81.3%(13/16)。PFS 7.0个月(95%CI5.4～8.5个月)。OS 12.1个月(95%CI10.2～14.1个月)。所有患者对毒副作用均可耐受,且多为Ⅰ度和Ⅱ度,无一例患者因为不可耐受化疗反应而终止治疗,未出现蛋白尿、胃肠穿孔、缺血性事件、静脉血栓栓塞事件、肺出血及致死性肺出血。结论贝伐珠单抗联合标准化疗方案可获得较好的疗效,且没有增加严重毒副作用的发生,其安全性较高。

Objective To investigate the short-and long-term efficacy of first-line chemotherapy with platinum-based two-drug regimens and bevacizumab in advanced non-squamous non-small cell lung cancer（NSCLC）,and to evaluate the safety of bevacizuma for clinical application. Methods Sixteen patients with NSCLC were treated with platinum-based two-drug regimens and bevacizumab.The short-term efficacy was evaluated after 6 cycles of chemotherapy.Progression-free survival（PFS） and overall survival（OS） were observed after treatment.Toxic side effects of drugs were recorded during chemotherapy.Results Among the 16 patients,complete remission was found in 1（6.3%）,partial remission in 7（43.8%）,stable disease in 5（31.2%） and progressive disease in 3（18.7%）.The objective response rate and disease control rate were 50.0%（8/16） and 81.3%（13/16）,respectively.The PFS and OS were 7.0 months（95% CI,5.4 to 8.5 months） and 12.1 months（95%CI,10.2 to 14.1 months）,respectively.Drugs were well tolerated in all patients（grade Ⅰ-Ⅱ）.No patients discontinued treatment because of intolerable response to chemotherapy,or had proteinuria,gastrointestinal perforation,ischemia,venous thromboembolism,pulmonary hemorrhage and fatal pulmonary hemorrhage.Conclusion The first-line chemotherapy with platinum-based two-drug regimens and bevacizumab is an effective and safe treatment without serious side effects in patients with NSCLC.