恩度联合国产培美曲塞一线治疗老年晚期肺腺癌的近期疗效观察

Observation of short-term clinical efficiency of domestic Endostar combined with domestic pemetrexed used in first-line for treatment of elderly patients with advanced lung adenocarcinoma

目的观察和比较重组人血管内皮抑素(恩度)联合国产培美曲塞(普来乐)与单药普来乐治疗晚期肺腺癌的近期疗效及不良反应。方法 81例经病理组织学或细胞学检查确诊的晚期肺腺癌初治患者分为恩度联合普来乐治疗组41例,普来乐单药对照组40例,两组同时给予普来乐500 mg/m2,第1天,治疗组恩度15 mg于化疗周期第1-14天使用,21天为1周期给药,完成2周期后评价疗效及不良反应,并随访至2012年5月30日。结果治疗组有效18例(43.9%),对照组有效9例(22.5%),治疗组有效率高于单药组(P<0.05)。治疗组出现临床受益反应(clinical benefit reponse,CBP)26例(63.4%),对照组出现CBR 15例(37.5%),两组CBR出现率的差异有统计学意义(P<0.05)。随访至2012年5月30日,治疗组和对照组中位无进展时间(progession-free survival,PFS)分别为6.3月和5.1月(P<0.05)。两组白细胞减少、胃肠道反应、肝功能损害等不良反应发生率的差异无统计学意义(P>0.05)。结论恩度联合国产培美曲塞(普来乐)一线治疗晚期肺腺癌具有较好的近期疗效,不良反应轻可耐受,值得临床进一步应用。

Objective To evaluate the short-term efficacy and side effect of endostatin injection （Endostar） combined with domestic pemetrexed in treatment of advanced lung adenocarcinoma. Methods Eighty-one patients with lung adenocareinoma confirmed by histopathology and/or cytology were divided into two groups. Forty-one patients received Endostar with pemetrexed （therapy group） and 40 patients were treated with pemetrexed chemotherapy alone （control group）. Two groups were treated with pemetrexed intravenously guttae 500 mg/㎡, dl ,therapy group received Endostar 15 rag/day from day 1 to 14, 21 days as one cycle, a total of two cycles. Then therapeutic and side effects were evaluated. These patients were followed up till May 30,2012. Results In therapy group,the overall response rate （CR and PR） was 43.9% , while that in control group was 22.5% （P 〈 0.05 ）. The clinical benefit response rate of therapy group was significantly higher than that of control group （ P 〈 0.05 ）. PFS in therapy group was 6.3 months,while that in control group was 5.1 months （P 〈 0.05 ） till May 30,2012. There were no significant differences between two groups in toxicities of myelosuppression, gastrointestinal tract, and liver （ P 〉 0.05 ）. Conclusions Endostar combined with domestic pemetrexed has good therapeutic efficacy in first-line for the treatment of patients with advanced lung adenocarcinoma, and side effect is tolerable and mild.