放疗联合重组人血管内皮抑素治疗肺癌脑转移瘤合并脑水肿的疗效评估

Evaluation of the efficacy of radiotherapy combined with recombinant human endostatin in the treatment of lung cancer with brain metastasis and brain edema

目的探讨放疗联合重组人血管内皮抑素(rh-Endostatin)治疗肺癌脑转移瘤合并脑水肿的疗效。方法选取2020-05—2023-03阜阳市肿瘤医院收治的肺癌脑转移瘤合并脑水肿患者74例为研究对象,按随机数排序法分为研究组37例与对照组37例,对照组予以放疗联合传统治疗(激素、甘露醇),研究组予以放疗联合rh-Endostatin治疗,均治疗2周,比较2组患者疗效、水肿程度、癌胚抗原(CEA)水平与不良反应。结果2组患者总有效率比较差异无统计学意义(χ^(2)=1.770,P>0.05),2组患者治疗2周后脑水肿程度均较治疗前改善(Z=17.704、6.211,P<0.05),且研究组优于对照组(Z=5.681,P<0.05)。重复测量方差分析结果显示,2组患者治疗后CEA水平与治疗前相比均降低,且治疗2周后CEA水平低于治疗1周后(P<0.05),研究组治疗1周后、治疗2周后CEA水平均低于对照组(6.12±2.01比7.45±2.03,4.31±1.14比5.52±1.77,P<0.05)。2组患者均未发生贫血、出血倾向、心功能不良反应,心律失常不良反应分级、血小板减少不良反应分级、粒细胞减少不良反应分级比较差异无统计学意义(P>0.05)。结论放疗联合rh-Endostatin治疗肺癌脑转移瘤合并脑水肿具有较好疗效,可有效改善脑水肿指数,降低CEA水平,且无明显不良反应,安全性较好。

Objective To investigate the efficacy of radiotherapy combined with recombinant human endostatin in the treatment of lung cancer with brain metastasis and brain edema.Methods A prospective study was conducted on 74 patients with lung cancer brain metastasis and brain edema admitted to Fuyang Cancer Hospital from May 2020 to March 2023.The patients were divided into the study group of 37 cases and the control group of 37 cases using random number ranking method.The control group received radiation therapy combined with traditional treatment(hormones,mannitol),while the study group received radiation therapy combined with recombinant human endostatin for 2 weeks.The efficacy,edema degree,and CEA levels and toxic side effects were compared between the two groups.Results The results of rank data showed that there was no significant difference between the two groups(P>0.05),and no significant difference between the two groups(χ^(2)=1.770,P>0.05).Grade data showed that the degree of cerebral edema improved after 2 weeks of treatment(Z=17.704,6.211,P<0.05),and the degree of cerebral edema of study group was better than the control group after 2 weeks(Z=5.681,P<0.05).The results of repeated measures ANOVA showed that CEA levels were lower after treatment compared with before treatment,and CEA levels after 2 weeks of treatment were lower 1 week after treatment(6.12±2.01 vs 7.45±2.03,4.31±1.14 vs 5.52±1.77,P<0.05),but the study group had lower CEA levels after 1 week and 2 weeks of treatment than the control group(P<0.05).Neither group had anemia,bleeding tendency,cardiac toxicity,and granulococytopenia(P>0.05).Conclusion Radiotherapy combined with recombinant human vascular endostatin in lung cancer brain metastasis combined with cerebral edema has good efficacy,which can effectively improve cerebral edema index,reduce CEA level,with no obvious toxic side effects and good safety.