重组人血管内皮抑素联合培美曲塞一线治疗老年性肺腺癌的临床观察

Clinical observation of recombinant human endostatin combined with pemetrexed in the first-line treatment of senile lung adenocarcinoma

目的探讨重组人血管内皮抑素联合培美曲塞一线治疗老年性肺腺癌的临床效果。方法选取老年肺腺癌患者155例,随机分为对照组(76例)和观察组(79例)。对照组患者采用单纯培美曲塞治疗,观察组患者在对照组基础上给予重组人血管内皮抑素联合治疗。评价两组患者的治疗效果,统计分析两组患者疾病进展时间、1年生存率和不良反应发生情况。结果两组患者均无完全缓解者,观察组患者中PR、SD、PD、有效率及临床收益率分别为48.1%、34.2%、17.7%、48.1%和82.3%;对照组患者中分别为25.0%、32.9%、42.1%、25.0%和57.9%,观察组患者有效率和临床收益率均高于对照组,差异有统计学意义(P<0.05)。观察组患者疾病进展时间((5.41±0.52)月)明显晚于对照组((2.84±0.33)月),1年生存率(62.0%)明显高于对照组(30.3%),差异均有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论重组人血管内皮抑素联合培美曲塞一线治疗老年肺腺癌可以取得良好的近期效果和远期疗效,而不会增加患者的不良反应,具有较高的安全性,可以在临床推广。

Objective To observe the effects of recombinant human endostatin combined with pemetrexed in the first-line treatment of elderly lung cancer. Methods 155 elderly patients with lung cancer were randomly divided into control group（ 76 patients） and observation group（ 79 patients）. Patients in the control group were treated with pemetrexed alone,patients in the observation group were treated with recombinant human endostatin combined with pemetrexed. Time to disease progression,1-year survival and adverse events were evaluated in these two groups. Results Complete remission（ CR） was not observed in the two groups. PR,SD,PD,efficiency and clinical benefit rate were 48. 1%,34. 2%,17. 7%,48. 1%,82. 3%,respectively in the observation group; 25. 0%,32. 9%,42. 1%,25. 0% and 57. 9%in the control group. Efficient and clinical benefit rate in the observation group were significantly higher than that in the control group,the difference was significant（ P〈0. 05）. Time to disease progression in the observation group（（ 5. 41 ± 0. 52） months） were significantly higher than that in the control group（（ 2. 84 ±0. 33） months）,1-year survival rate of the observation group（ 62. 0%） was higher than that in the control group（ 30. 3%）,the difference was significant（ P〈0. 05）. Adverse reaction rate in these two groups had no significant difference（ P〈0. 05）. Conclusion Recombinant human endostatin combined with pemetrexed in the first-line treatment of elderly lung cancer can achieve good short-term and long-term effects without increasing adverse reactions,which had high security,it worthy to be promoted in clinical practice.