重组人血管内皮抑制素联合斑蝥酸钠维生素B_6辅助治疗晚期非小细胞肺癌的临床观察

Clinical Observation of Rh- endostatin Combined with Cantharidin Sodium Vitamin B_6 in the Treatment of Advanced Non-small Cell Lung Cancer

目的:探讨重组人血管内皮抑制素联合斑蝥酸钠维生素B_6辅助治疗晚期非小细胞肺癌(NSCLC)的临床疗效及安全性。方法:180例确诊为晚期NSCLC的患者采用随机数字表法分为甲、乙、丙组,各60例。3组患者均采用吉西他滨+顺铂(GP)方案进行化疗;乙组患者在此基础上加用重组人血管内皮抑制素注射液7.5 mg/m^2,静脉滴注3 h,d1~14;丙组患者在乙组治疗的基础上加用斑蝥酸钠维生素B_6注射液40 ml静脉滴注,qd,d1~14。每21天为1个周期,2个周期后作疗效评估。观察3组患者的临床获益率、生存质量改善率、肿瘤进展时间(TTP)及不良反应发生情况。结果:甲、乙、丙组患者的临床获益率分别为40.0%、58.3%、71.6%,生存质量改善率分别为28.3%、41.7%、56.7%,组间比较差异均有统计学意义(P<0.05)。甲、乙、丙组患者的中位TTP分别为126、190、195 d,乙、丙组患者的TTP明显长于甲组,差异均有统计学意义(P<0.05);但乙组和丙组之间比较差异无统计学意义(P>0.05)。丙组患者的白细胞下降、血小板降低及恶心呕吐发生率均明显低于甲、乙组,差异有统计学意义(P<0.05);但甲组和乙组之间比较差异无统计学意义(P>0.05)。结论:重组人血管内皮抑制素联合斑蝥酸钠维生素B_6在GP化疗方案的基础上能显著提高晚期NSCLC患者的化疗效果,同时降低化疗药物产生的毒副反应,提高患者生存质量,延长患者生存时间。

OBJECTIVE： To investigate the clinical efficacy and safety of rh-endostatin combined with cantharidin sodium vitamin B6 in the treatment of advanced non-small ceU lung cancer （NSCLC）. METHODS： 180 patients diagnosed as advanced NSCLC were divided into group A, group B and group C , with 60 cases in each group according to random number table method. 3 groups were all given gemcitabine＋cisplatin （GP） chemotherapy plan; Group B additionally received Rh-endostatin injection 7.5 mg/m2 intravenously for 3 h, d1-14; group C was additionally given Cantharidin sodium vitamin B6 injection 40 ml intravenously, qd, d1-14, on the basis of group B. every 21 days for a cycle, evaluation of therapeutic effect after 2 cycles. The clinical benefit rate, quality improvement rate of life, time to progression （TTP） and the occurrence of ADR were observed in 3 groups. RESULTS： The clinical benefit rate of groups A, B and C were 40.0%, 58.3%, 71.6% respectively, the quality improvement rate of life in 3 groups were 28.3%, 41.7%, 56.7% respectively, the differences were statistically significant among those groups （P〈 0.05）. The median TTP of groups A, B and C were 126, 190 and 195 days, TTP of groups B and C were significantly longer than that of group A, with statistical significance （P〈0.05） ; there was no significant difference between group B and group C （P〉 0.05）. The rates of leukopenia, thrombocytopenia, nausea and vomiting in group C were significantly lower than those of group A and B, with statistical significance （P〈0.05） ; there was no statistical significance between group A and B （P〉0.05）. CONCLUSIONS ： Rh-endostatin combined with cantharidin sodium vitamin B6 can significantly improve the effectiveness of chemotherapy in patients with advanced NSCLC on the basis of the GP chemotherapy, while reduce the toxicity of chemotherapy dlugs, improve the quality of life and prolong the survival time.