重组人血管内皮抑制素持续静脉泵注联合含铂两药化疗治疗不同病理类型非小细胞肺癌的疗效分析

Efficacy of continuous intravenous infusion of recombinant human endostatin combined with platinum-based doublet chemotherapy in the treatment of non-small cell lung cancer with different pathological types

目的分析重组人血管内皮抑制素(恩度)持续静脉泵注联合含铂两药化疗治疗晚期不同病理类型非小细胞肺癌(NSCLC)的疗效及安全性。方法根据病理类型将本院2013年1月至2018年12月收治的73例晚期NSCLC患者分为鳞癌组44例和非鳞癌组29例,均接受恩度便携式输液泵持续静脉泵注(每次15 mg/m 2,每日1次,连续7天)联合常规含铂两药化疗(21天为1个周期)。分别采用实体瘤疗效评价标准(RECIST)1.1版和美国国家癌症研究所常见不良反应事件评价标准(NCI-CTC AE)3.0版评估疗效和不良反应,根据随访数据进行生存分析。结果73例患者均可评价疗效,客观缓解率(RR)和疾病控制率(DCR)分别为35.6%(26/73)和87.7%(64/73),中位无进展生存期(PFS)和总生存期(OS)分别为6.0和16.5个月,其中非鳞癌组的RR和DCR分别为17.2%(5/29)和89.7%(26/29),中位PFS和OS分别为7.7和18.1个月,鳞癌组的RR和DCR分别为47.4%(21/44)和89.7%(38/44),中位PFS和OS分别为5.6和16.3个月。鳞癌组的RR高于非鳞癌组(P=0.008),两组DCR、PFS和OS的差异无统计学意义(P>0.05)。常见不良反应为白细胞减少和消化道反应,出血仅发生1例,无停药或致死性事件发生。结论持续静脉泵注恩度联合含铂两药化疗治疗晚期NSCLC患者的有效率高,生存期可观且安全性良好,为晚期NSCLC患者,尤其是鳞癌患者提供了更多的治疗选择,值得临床中推广应用。

Objective To analyze the efficacy and safety of continuous intravenous infusion of recombinant human endostatin(Endostar)combined with platinum-based doublet chemotherapy in the treatment of advanced non-small cell lung cancer(NSCLC)with different pathological types.Methods According to the pathological types,73 patients with advanced NSCLC in our hospital from January 2013 to December 2018 were divided into squamous cell carcinoma group(44 cases)and non-squamous cell carcinoma group(29 cases).All patients received continuous intravenous infusion of Endostar portable infusion pump(15 mg/m 2 per time,once a day for 7 days)combined with conventional platinum-based doublet chemotherapy(21 days as a cycle).The efficacy and adverse reactions were evaluated by Response Evaluation Criteria in Solid Tumors(RECIST)version 1.1 and National Cancer Institute Common Terminology Criteria for Adverse Events(NCI-CTC AE)version 3.0,respectively.The survival analysis was performed according to the follow-up data.Results All 73 patients were evaluated for response with the objective response rate(RR)of 35.6%(26/73),disease control rate(DCR)of 87.7%(64/73),median progression free survival(PFS)of 6.0 months and median overall survival(OS)of 16.5months.As for non-squamous cell carcinoma group,the RR and DCR were 17.2%(5/29)and 89.7%(26/29)with the median PFS and OS of 7.7 and 18.1 months.The RR and DCR were 47.4%(21/44)and 89.7%(38/44)in squamous cell carcinoma group with the median PFS and OS of 5.6 and 16.3 months.RR in squamous cell carcinoma group was higher than that in non-squamous cell carcinoma group(P=0.008).There was no significant difference in DCR,PFS and OS between both groups(P>0.05).The common adverse reactions were leucopenia and gastrointestinal reactions.There was only one case of bleeding,and no drug withdrawal or fatal events occurred.Conclusion Continuous intravenous infusion of recombinant human endostatin combined with platinum containing chemotherapy in the treatment of patients with advanced NSCLC has high effective rate,considerable survival and good safety,which provides more treatment options for patients with advanced NSCLC,especially for patients with squamous cell carcinoma,and is worthy of clinical application.