重组人血管内皮抑素联合化疗治疗中晚期非小细胞肺癌的临床观察

[摘要] 目的 观察重组人血管内皮抑素（恩度）对中晚期非小细胞肺癌的疗效。 方法 回顾性分析2008年5月～2011年5月间我院65例中晚期非小细胞肺癌临床资料。其中GP组32例接受GP方案化疗[（吉西他滨1000 mg/m2，d1+d8）、顺铂（20 mg/m2，d1～5）]；联合组33例在GP方案基础上同时加用恩度（15 mg/d，d1～14）。两组患者均接受4～6周期化疗。观察比较两组患者近期疗效、功能状态评分、不良反应及生存率。 结果 联合组近期疗效明显优于GP组（P=0.0390），联合组总有效率明显优于GP组（P=0.0467）；两组在不良反应方面无明显差异，均无化疗相关性死亡病例发生；化疗结束3个月后联合组KPS评分明显优于GP组[（91.52±11.25） vs （85.74±10.97），（P=0.0401）]； GP组3年生存率21.88%，联合组3年生存率27.27%，联合组明显高于GP组（P=0.0425）。 结论 恩度联合GP方案化疗治疗晚期非小细胞肺癌可明显提高临床疗效，提高生存率，且耐受性好，值得临床推广应用。

[关键词] 非小细胞肺癌；化疗；重组人血管内皮抑素；生存率

[中图分类号] R734.2 [文献标识码] B [文章编号] 1673-9701（2016）13-0105-04

Effect of recombinant human endostain combined with chemotherapy on advanced non-small cell lung cancer

WANG Jiabao TANG Chengwu FENG Wenming

Department of Surgery， the First People's Hospital Affiliated to Huzhou University Medical College， Huzhou 313000， China

[Abstract] Objective To investigate the effect of recombinant human endostain combined with chemotherapy on advanced non-small cell lung cancer. Methods Medical documents of 65 patients with advanced non-small cell lung cancer during May 2008 and May 2011were retrospectively reviewed. Patients were divided into GP group and combination group. In GP group， 32 patients received Gemcitabine （1000 mg/m2 on d1 and d8） and cisplatin （20 mg/m2 d1-5） by intravenous injection. While in combination group， 33 patients received additional recombinant human endostain （15 mg/d， d1-14） by intravenous injection concurrently with the same chemotherapy as GP group. Patients accepted chemotherapy every 3 weeks for 4-6 cycles. Short-term response rate， long-term survival， KPS score and adverse effects were compared. Results Significantly higher short-term response rate （P=0.0390） and RR （P=0.0467） were found in combination group. No chemotherapy-related death was observed. No significant difference was found in adverse effects between two groups. KPS score of combination group was significantly better than that of GP group（91.52±11.25 vs 85.74±10.97， P=0.0401）. Combination group was found to have a significantly higher 3-year survival probability than GP group （27.27% vs 21.88%， P=0.0425）. Conclusion The combination of recombinant human endostain and GP chemotherapy lead to a better short-term RR and a higher 3-year survival probability without increasing adverse effects.

[Key words] Non-small cell lung cancer； Chemotherapy； Recombinant human endostain； Survival probability

近年来在全世界范围内肺癌每年的发病率都处于恶性肿瘤的首位，对人类的健康和生命产生了严重的威胁。在全部的肺癌患者中，非小细胞肺癌占80%左右[1，2]，由于非小细胞肺癌的早期临床表现并不明显，很难在早期诊断发现，因此在就诊时已经是中晚期，甚至失去手术机会，所以现阶段中晚期非小细胞肺癌的首选治疗方法仍然是化疗[3]。但迄今为止，化疗有效率还不尽如人意，近年来有学者发现重组人血管内皮抑素可有效地抑制肿瘤血管的生成，并逐渐成为目前恶性肿瘤治疗的新策略[4]。本研究采用重组人血管内皮抑素（恩度）联合GP方案化疗（吉西他滨和顺铂）联合治疗中晚期非小细胞肺癌，取得显著的效果，现报道如下。