恩度联合同步放化疗治疗局部晚期非小细胞肺癌

Clinical study of Rh-endostatin combined with chemotherapy followed by concurrent radiotherapy for the treatment of locally advanced non-small cell lung cancer

目的:研究恩度联合同步放化疗治疗局部晚期非小细胞肺癌(NSCLC)的临床效果及毒副反应。方法:选择42例经病理证实的局部晚期NSCLC患者,随机分为试验组和对照组。试验组采用调强放射治疗(IMRT)。放疗剂量每次2.0 Gy,每天1次,每周5 d,总剂量60 Gy,同步行NP方案+恩度治疗,恩度剂量为7.5 mg/m2(一般为15 mg/次)加生理盐水500 ml中缓慢静脉滴注,滴注时间为3 h,给予的时间是放化疗前30 min开始,连续给药14 d,间歇14 d重复。长春瑞滨25 mg/m2,静脉滴注,d1,d8;顺铂20 mg/m2,静脉滴注,d1-4,每4周重复1次,化疗2个周期。对照组采用同步放化疗,具体方法同治疗组。结果:42例患者均可评价。试验组和对照组总有效率RR(CR+PR)分别为71.43%(15/21)和52.38%(11/21)(P>0.05),疾病控制率DCR(CR+PR+SD)分别为90.48%(19/21)和80.95%(17/21)(P>0.05),中位无疾病进展生存时间分别为16.8个月和15.3个月,1年生存率分别为66.67%和61.90%,两组比较差异无显著性(P>0.05)。两组不良反应发生率比较差异无显著性(P>0.05)。结论:恩度联合同步放化疗和同步放化疗相比治疗局部晚期非小细胞肺癌疗效没有明显差异,毒副反应也相似。

Objective ： To study the simultaneous release of Rh-endostatin combined with concurrent chemoradiotherapy for the treatment of locally advanced non-small cell lung cancer （NSCLC） , the clinical efficacy and toxicity. Methods： 42 patients with pathologically confirmed locally advanced NSCLC were randomly divided into trial group and control group. The trial group were treated with intensity modulated radiation therapy （IMRT）. Target dose was 60 Gy, which was divided to 5 times/week and 2 Gy/time. synchronous line NP programs ＋ Rh-endostatin treatment, Rh-endostatin daily 15 mg, ivgtt, 1- 14 d; Vinorelbine 25 mg/m2, ivgtt, dl, dS; cisplatin 20 mg/m2, ivgtt,dl, d2, d3, dd, repeated every four weeks, chemotherapy 2 cycles. The control group was treated with simultaneous radiotherapy and chemotherapy, similar to the trial group. Results： 42 patients were available for evaluation. The response rate of the trial group and control group was respectively 71.43% （15/21） and 52.38% （11/21）. The disease control rate of the trial group and control group was respectively 90.48% （ 19/21 ） and 80.95% （ 17/21 ）. The former was simliar to the latter （P 〉 O. 05 ）. In trial group and control group, the median progression-free survival and 1-year survival rate were similar, the two groups showed no significant difference （P 〉 0. 05 ）.The incidence of adverse reactions between the two groups showed no significant difference （P 〉0.05）. Conclusion： There was no difference on clinical effect between the two groups in patients with locally advanced non-small cell lung cancer. The clinical efficacy and toxieities of trial group is similar to that of control group.