重组人血管内皮抑制素对宫颈癌放疗增敏作用的研究

Effect of recombinant human endostatin on sensitization of radiotherapy in cervical cancer

目的:研究重组人血管内皮抑制素对宫颈癌放疗的增敏作用。方法:选取大连医科大学附属第二医院2017年7月至2018年11月中晚期宫颈癌(ⅡB~ⅣA期)患者60例,将患者按随机数字表法分为两组:试验组(30例)采用重组人血管内皮抑制素联合同步放化疗治疗,对照组(30例)采用单纯同步放化疗治疗。检测两组患者治疗前1周和治疗后1周内血清血管内皮生长因子(VEGF)和碱性成纤维细胞生长因子(bFGF)水平,于治疗后3个月评价近期疗效。结果:试验组客观缓解率(ORR)和疾病控制率(DCR)高于对照组[93%(28/30)比87%(26/30)和97%(29/30)比93%(28/30)],但差异无统计学意义(P>0.05)。两组不良反应发生情况比较差异无统计学意义(P>0.05)。两组治疗后血清VEGF和bFGF均明显低于治疗前[试验组:(88.07±37.53)ng/L比(227.27±142.61)ng/L和(21.03±5.75)ng/L比(38.34±18.17)ng/L,对照组:(120.04±81.22)ng/L比(197.34±142.41)ng/L和(24.04±7.29)ng/L比(39.78±13.35)ng/L],差异有统计学意义(P<0.01);试验组治疗后血清VEGF和bFGF低于对照组,但差异无统计学意义(P>0.05)。结论:对于中晚期宫颈癌患者,重组人血管内皮抑制素联合同步放化疗有进一步下调患者血清VEGF、bFGF水平、提升放化疗敏感性和近期疗效的趋势。

Objective To study the radiotherapy sensitization of recombinant human endostatin in patients with cervical cancer.Methods Sixty patients with advanced cervical cancer(stageⅡB toⅣA)from July 2017 to November 2018 in the Second Affiliated Hospital of Dalian Medical University were selected.The patients were divided into experimental group and control group according to random number table with 30 cases each.The patients in experimental group were treated with recombinant human endostatin combined with concurrent chemoradiotherapy,while the patients in control group only received chemoradiotherapy.The serum levels of vascular endothelial growth factor(VEGF)and basic fibroblast growth factor(bFGF)were measured 1 week before treatment and 1 week after treatment,and short-term efficacy was evaluated 3 months after treatment.Results The objective remission rate(ORR)and disease control rate(DCR)in experimental group were higher than those in control group:93%(28/30)vs.87%(26/30)and 97%(29/30)vs.93%(28/30),but there were no statistical differences between 2 groups(P>0.05).There was no statistically significant difference in the occurrence of adverse reactions between 2 groups(P>0.05).Compared with that before treatment,the serum VEGF and bFGF after treatment were significantly lower,experimental group:(88.07±37.53)ng/L vs.(227.27±142.61)ng/L and(21.03±5.75)ng/L vs.(38.34±18.17)ng/L,control:(120.04±81.22)ng/L vs.(197.34±142.41)ng/L and(24.04±7.29)ng/L vs.(39.78±13.35)ng/L,and there were statistical differences(P<0.01);after treatment,the serum VEGF and bFGF in experimental group were lower than those in control group,but there were no statistical difference between 2 groups(P>0.05).Conclusions For patients with advanced cervical cancer,recombinant human endostatin combined with concurrent chemoradiotherapy can further decrease the serum levels of VEGF and bFGF,improve the sensitivity of chemoradiotherapy,and enhance the short-term efficacy.