诱导化疗并三维适形放疗加重组人血管内皮抑制素治疗局部晚期非小细胞肺癌  

Effect of induction chemotherapy and three-dimensional conformal radiation （3D-CRT） combined with endostar in the treatment of locally advanced non-small cell lung cancer

作　　者：张庆宏[1] 林连兴[1] 陈楚云[1] 徐志渊[1] 蔡舜吼[1] 

机构地区：[1]中山大学附属汕头医院肿瘤放疗科,广东省汕头515041

出　　处：《中国基层医药》2013年第13期1959-1961,共3页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的观察诱导化疗并三维适形放疗加重组人血管内皮抑制素治疗局部晚期非小细胞肺癌的疗效及毒副反应。方法将30例局部晚期NSCLC患者按随机数字表法分为两组，观察组15例：采用诱导化疗＋重组人血管内皮抑制素＋放疗，第1天，第8天，长春瑞滨25mg／m2，第2～4天，顺铂30mg／m2；第1—14天，重组人血管内皮抑制素注射液7．5mg／m2，间隙7d后，重复使用，共2—4个疗程。对照组15例：采用诱导化疗＋放疗，第1天，第8天，长春瑞滨25mg／m2＋第2—4天，顺铂30mg／m2。放疗均采用三维适形放疗，处方剂量为60～68Gy／30—34次。用WHO的标准评价疗效，比较有效率、毒副反应、中位无进展生存时间、1年生存率。结果观察组和对照组总有效率（CR＋PR）分别为66．7％和60．0％，（P〉0．05）。观察组和对照组中位无进展生存时间分别是12个月和10个月。观察组和对照组中位生存时间分别是20个月和18个月。两组1年总生存率分别为80．0％（12／15）和73．3％（11／15），（P〉0．05）。两组主要毒副反应为血液毒性、胃肠道反应、放射性食管炎和放射性肺炎，但差异无统计学意义（P〉0．05）。结论重组人血管内皮抑制素联合诱导放化疗治疗局部晚期非小细胞肺癌在客观缓解率和总生存率方面均有所提高，毒副反应可以耐受，但差异无统计学意义，其结果有待进一步的随机多中心Ⅲ期临床研究。Objective To evaluate the efficacy and safety of induction chemotherapy and three-dimensional confQrmal radiation（3D-CRT） combined with endostar in the treatment of locally advanced non-small cell lung cancer （NSCLC）. Methods Thirty patients with locally advanced NSCLC were enrolled and divided into observation group （15 cases） and control group （15 cases）. In the observation group,the patients received induction chemotherapy and 3D-CRT combined with endostar. Chemotherapy： Vinorelbine 25mg/m2 on day 1 and 8, DDP 30mg/m2 on day 2 to 4. Endostar 7.5mg/m2 on day 1 to 14,which was used again after 7 days for 2 to 4 cycles. In the control group,the pa- tients received induction chemotherapy and 3D-CRT at the same dosage. All patients were treated with 3D-CRT and the prescription dose was 60 - 68Gy per fraction. The responses were evaluated according to WHO criteria. The shortterm efficacy between the 2 groups was compared. Results The overall effective rate of the two groups were 66. 7% and 60.0%, respectively（ P 〉 0.05 ）. The median progression-free survival time was 12 months in the observation group and 10 months in the control group. The median survival time was 20 months in the observation group and 18 months in the control group. The 1 year overall survival rate was 80.0% in the observation group and 73.3% in the control group （P 〉 0.05 ）. The main toxicities in the two groups were marrow suppression, gastrointestinal symptoms, a- cute radiation pneumonitis and acute radiation esophagitis. There was no significant difference between the two groups （ P 〉 0.05）. Conclusions The combination of endostar with induction chemotherapy and 3D-CRT can improve the short-term efficacy rate of locally advanced NSCLC, the adverse events of which are tolerable, but the improvement is not significant in both groups. The result pending further randomized multi-center phase RI clinical study.

关 键 词：癌 非小细胞肺 内皮抑素类 长春瑞滨 放射疗法 适形 

分 类 号：R734.2[医药卫生—肿瘤]