重组人血管内皮抑制素治疗晚期非小细胞肺癌的效果及对血清 促红细胞生成素及其受体表达情况的影响

Efficacy of recombinant human endostatin injection in treatment of advanced nonsmall cell lung cancer and effect on serum erythropoietin and receptor expression

目的探讨重组人血管内皮抑制素治疗晚期非小细胞肺癌(NSCLC)的临床效果及对血清促红细胞生成素(EPO)及其受体表达情况的影响。方法采用随机数字表法将122例晚期NSCLC患者随机分为联合组与对照组,各61例。两组患者均采用多西他赛+铂类药物(DP)方案进行化疗,联合组患者在此基础上采用重组人血管内皮抑制素进行治疗。比较两组患者的近期化疗效果、血清EPO mRNA水平、促红细胞生成素受体(EPOR)mRNA水平、不良反应发生情况及无进展生存情况。结果两组患者的总有效率比较,差异无统计学意义(P﹥0.05)。化疗后,两组患者的血清EPO mRNA、EPOR mRNA水平均较本组化疗前降低,且联合组患者的血清EPO mRNA、EPOR mRNA水平均低于对照组,差异均有统计学意义(P﹤0.05)。化疗过程中,联合组患者恶心、呕吐的发生率均高于对照组,差异均有统计学意义(P﹤0.05)。随访12个月,无失访患者。联合组患者的中位无进展生存时间为10.0个月,长于对照组患者的7.0个月,差异有统计学意义(P﹤0.05)。结论与单纯一线化疗方案相比,一线化疗联合重组人血管内皮抑制素治疗虽然不能较大程度地改善晚期NSCLC患者的近期化疗效果,但在延长肿瘤无进展生存时间方面具有一定的临床应用价值。

Objective To explore the efficacy of recombinant human endostatin injection in the treatment of patients with advanced non-small cell lung cancer(NSCLC)and effect on serum erythropoietin(EPO)and receptor expression.Method A total of 122 advanced NSCLC patients were divided into combination group[n=61,treated with docetaxel+platinum(DP)+recombinant human endostatin injection]and control group(n=61,treated with DP).The short-term efficacy,the level of serum EPO mRNA and erythropoietin receptor(EPOR)mRNA,adverse reactions and progression-free survival were compared between the two groups.Result There was no significant difference for the total effective rate between the two groups(P>0.05).The serum EPO mRNA and EPOR mRNA both decreased after chemotherapy within the same group,with lower levels in the combination group than those in the control group,and the differences were statistically significant(P<0.05);the incidence of nausea and vomiting in the combination group was higher than that in the control group,and the differences were statistically significant(P<0.05);there were no patients lost to follow-up after 12 months of follow-up.There was significant difference for the median progression-free survival time between combination group and control group(10.0 months vs 7.0 months,P<0.05).Conclusion The fiirst-line chemotherapy combined recombinant human endostatin injection has certain clinical value in prolonging the progression-free survival time in the treatment of advanced NSCLC with moderate improvement for short-term chemotherapy effect than the first-line chemotherapy.