重组人血管内皮抑素联合化疗治疗晚期胃癌的临床观察

Clinical observation of recombinant human endostatin in combination with chemotherapy in the treatment of advanced gastric cancer

目的观察重组人血管内皮抑素(恩度)联合化疗治疗晚期胃癌的有效性及安全性。方法观察2009年5月～2012年7月辽西地区三甲医院收治的40例接受恩度联合化疗的晚期胃癌患者近期疗效及毒副反应。每2周期进行疗效评价,计算总有效率(RR),以CR+PR+SD计算疾病控制率(DCR),同时评价不良反应。结果 40例患者完全缓解(CR)6例,部分缓解(PR)13例,稳定(SD)15例,疾病进展(PD)6例,总有效率(RR)为47.5%,疾病控制率(DCR)为85%。入组患者无一例患者因无法耐受副反应而中止治疗。依据RECIST标准和WHO毒性反应分级标准,血液系统:白细胞减少28例(Ⅰ度11例,Ⅱ度8例,Ⅲ度6例,Ⅳ度3例,其中粒细胞减少性发热6例);胃肠道毒性反应45例(口腔黏膜炎3例,食欲不振、恶心、呕吐32例,出现难治性呃逆2例,腹泻13例);周围神经毒性反应Ⅰ度21例,Ⅱ度5例。结论恩度与化疗药联合使用具有一定的协同作用,其毒性低,安全性好,可适当改善晚期胃癌患者的生活质量,值得临床推广和进一步研究。

Objective To observe the recombinant human endostatin combination chemotherapy in advanced gastric cancer effectiveness and security. Methods 40 cases admitted to the hospitals in western Liaoning Province from May 2009 to July 2012 used the recombinant human endostatin combined with chemotherapy in patients with advanced gastric cance, the efficacy and toxicity were observed. Every 2 cycles the efficacy evaluation, calculation of efficiency （RR）, disease control rate （DCR） were done, as well as the evaluation of adverse reactions. Results 40 patients with complete remission （CR） 6 cases, partial remission （PR） of 13 cases, stable （SD） of 15 cases, disease progression （PD） of 6 cases, the total effective rate （RR） was 47.5%, disease control rate （DCR） was 85%. No cases appeared that could not be tolerated and discontinuation of treatment. 28 cases of patients with leucopenia （11 cases of grade I, 8 cases of Ⅱ grade, 6 cases of grade Ⅲ, 3 cases of grade Ⅳ, 6 cases of febrile neutropenia）; 45 cases were of gastrointestinal side effects （oral mucositis in 3 cases, 32 cases of loss of appetite, nausea, vomiting, intractable hiccups in 2 cases, 13 cases of diarrhea）; peripheral nerve toxicity reaction （ Ⅰ level） of 21 cases; peripheral nerve toxicity （ Ⅱ level） of 5 cases. Conclusion Endostar with chemotherapy drugs used in combination with a certain degree of synergy, its low toxicity, well security, may be appropriate to improve the quality of life of patients with advanced gastric cancer, is worthy of clinical and further study.