恩度联合放化疗治疗中晚期食管癌的临床观察

Clinical observation of Endostar combined with chemoradiotherapy for patients with locally ad- vanced esophageal carcinoma

目的探讨恩度联合放化疗治疗局部中晚期食管癌患者的近期疗效。方法将55例患者随机分为实验组28例和对照组27例，两组均采用三维适形放疗60—66Gy和5-FU／DDP化疗，实验组从放疗起每天接受恩度静脉滴注7．5ms／m2，第1—14天，连用2个周期。治疗结束后比较两组有效率、无进展生存期、生存率及不良反应，同时检测治疗前后血清血管内皮生长因子（VEGF）浓度。结果实验组和对照组有效率为89．0％和74．1％（P=0．226）；1、2、3年总生存率分别为71．9％、50．0％、34．3％和52．0％、33．3％、20．0％（P=0．046）；无进展生存期为15个月和8个月（P=0．015）。无明显恩度相关的不良反应。两组血清VEGF水平治疗后比较差异有统计学意义（P=0．009）。结论恩度联合放化疗治疗食管癌疗效显著，能同时降低血清VEGF水平，且耐受性良好。

Objective To investigate the short-term effect of recombinant human endostatin （Endostar） combined with chemoradiotherapy（CRT） on patients with locally advanced esophageal squamous cell carcinoma（ESCC）. Methods Twenty-eight patients were treated with Endostar plus CRT（group E） and 27 patients were treated with CRT（group C）. All the patients received three-dimensional conformal radiotherapy of 60-66 Gy and concurrent chemotherapy of 5 fluorouracil and cisplatin. Endostar was administered at a dose level of 7.5 mg/（m2 · d） on the day of CRT（d 1-14）and 2 cycles were given. The response rate （RR）, progression free survival（PFS）, overall survival rate （OS） and side effects were assessed after treatment. The serum VEGF（S-VEGF） levels were measured before and after the treatment in both groups. Restilts The RR in group E was 89. 0% and 74. 1% in group C（P =0. 226）. The 1,2,30S rate was 71.9%, 50. 0% ,34. 3% and 52. 0%, 33. 3% ,20. 0% （P =0. 046）, PFS were 15 months and 8 months for group E and group C respectively（P =0. 0015）. There were no side effects associated with Endostar. There were significant differences in S-VEGF level after treatment（P =0. 009） between the two groups. Conclusions The effect of Endostar combined with chemoradiotherapy on patients with locally advanced esophageal squamous cell carci- noma is remarkable, it can reduce the S-VEGF level, and has good tolerance.