重组人血管内皮抑素静脉泵入联合窗口期化疗治疗晚期非小细胞肺癌的临床观察

Clinical observation of recombinant human endostatin durative transfusion combined with window period chemotherapy in advanced non-small cell lung cancer

目的探讨重组人血管内皮抑素（恩度）静脉泵入联合窗口期化疗在晚期非小细胞肺癌（NSCLC）治疗中的疗效及安全性。方法 2012年2月至2013年12月34例ⅢB~Ⅳ期NSCLC患者采用恩度持续静脉泵入联合窗口期化疗。具体方案：恩度15mg/m2每天持续24h静脉泵入,连续7d;在第4天窗口期接受含铂两药方案化疗;21天为1周期。治疗2~6个周期,每2个周期评价疗效,每周期记录不良反应。结果 34例患者均完成至少2个周期的治疗,获完全缓解1例,部分缓解14例,稳定8例,进展11例,有效率（RR）为44.1%;其中非鳞癌患者的RR为38.9%,鳞癌患者的RR为50.0%;一线治疗患者的RR为53.9%。治疗过程中与恩度相关的主要毒副反应为：2级窦性心动过速1例,2级高血压1例;无1例出现出血等严重毒副反应。结论恩度（15mg/m2）静脉泵入联合窗口期化疗治疗晚期NSCLC的近期疗效较好,不良反应无明显增加,值得临床进一步扩大样本量进行研究。

Objective To investigate the safety and efficacy recombinant human endostatin（ endostar） durative transfusion combined with window period chemotherapy in advanced non-small cell lung cancer（ NSCLC）. Methods From February 2012 to December 2013,34 cases of ⅢB-Ⅳ NSCLC patients were treated with endostar（ 15 mg / m2） durative transfusion combined with window period chemotherapy. Endostar was durative transfused every 24 hours for 7 days,and in the fourth day of the window period patients were received combined chemotherapy based on platinum,21 days was a cycle. All patients were received 2-6 cycles; efficacy was evaluated every 2 cycles,and side effects were recorded every 1 cycle. Results Every patient was received at least 2 cycles,got 1 CR,14 PR,8 SD and 11 PD. The response rate（ RR） of 34 patients was 44. 1%,and non-squamous carcinoma was 38. 9%,squamous carcinoma was 50. 0%. Fist-line treatment of patients showed higher RR（ 53. 9%）. Major toxicities related with endostar were sinus tachycardia in1 case,and 1 case of hypertension. No serious side effects such as bleeding were observed. Conclusion Endostar（ 15mg/m2） durative transfusion combined with window period chemotherapy for NSCLC was safety and efficacy,and a large prospective randomized controlled clinical study is worth to carry out in future.