内皮抑素联合放疗治疗肺癌脑转移及其获益人群筛选的临床研究  

Preliminary clinical study of recombinant human endostatin combined with radiotherapy in the treatment of brain metastases of non-small cell lung cancer and the patients suitable for this therapy

作　　者：蒋晓东[1] 丁曼华[1] 乔云[1] 刘毅[1] 刘亮[1] 戴鹏[1] 宋大安[1] 

机构地区：[1]连云港连云港市第一人民医院肿瘤放疗科,222002

出　　处：《中华行为医学与脑科学杂志》2014年第2期122-125,共4页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：国家自然科学基金（81272558）,卫生部课题基金（W201210）,中华国际医学交流基金（CIMF-F-H001-250）,江苏省自然科学基金（BK2012661）

摘　　要：目的 评价内皮抑素联合放疗治疗肺癌脑转移瘤的临床疗效及其获益人群.方法 采用随机数字表分层随机方法,将80例肺癌脑转移瘤患者分为联合组和单放组,观察两组患者的近期有效率、总生存时间、脑水肿指数变化、不良反应；同时用免疫组化方法检测80例患者原发病灶中血管内皮生长因子受体2 （VEGFR2）蛋白表达情况,并对以上观察指标进行亚组分析.结果 内皮抑素联合放疗治疗肺癌脑转移瘤,和单纯放疗相比,能够明显改善脑水肿（t=4.9,P=0.000）,没有明显的毒副反应（P＞0.05）；在近期有效率方面,在总体人群（n=80）组中虽然有提高（90％ vs 75％,x2=3.11,P=0.07）,但差异无统计学意义；然而在VEGFR2阳性亚组（93％ vs 67.7％,x2=6.31,P=0.012）分析中,差异有统计学意义.在总生存率（OS）方面,总人群组（P=0.35,95％ CI：0.25～1.30）和VEGFR2阳性亚组（P=0.109,95％ CI：0.40～ 1.34）中联合内皮抑素治疗,中位生存时间均未见获益.结论 内皮抑素联合放疗同步治疗肺癌脑转移瘤,在VEGFR2蛋白高表达人群中,疗效显著,能够明显改善脑水肿,提高近期有效率,无明显的并发症和毒副反应.Objective To investigate the therapeutic effects of recombinant human endostatin （RHES） combined with radiotherapy on brain metastases （BM） of non-small cell lung cancer （NSCLC） and the patients suitable for this therapy.Methods Eighty patients with BM of NSCLC were randomly divided into RHES combined with radiotherapy group （combination group） and radiotherapy alone group （each group with 40 patients）.The short-term effective rate,overall survival time,cerebral edema index and adverse reactions were observed and the expressions of vascular endothelial growth factor receptor 2 （VEGFR2） protein in primary lesions were detected with immunohistochemical method in all patients.Results Compared with radiotherapy alone group,brain edema was significantly relieved （t=4.9,P=0.000） and there were no marked adverse reactions in combination group.In short-term effective rate,there was no statistical significance in total population （n=80,90％ vs.75％,x2=3.11,P=0.07）,but there was statistical significance in the patients with positive VEGFR2 （93％ vs.67.7％,x2=6.31,P=0.012）.In overall survival time,there was no statistical significance in total population （n=80,P=0.35,95％ CI：0.25-1.30） or in the patients with positive VEGFR2 （P=0.109,95％ CI：0.40-1.34）.Conclusion Compared with radiotherapy alone,RHES combined with radiotherapy can relieve brain edema in the patients with BM of NSCLC and obtain better short-term effective rate in the patients with positive VEGFR2.

关 键 词：内皮抑素 放射治疗 血管内皮生长因子受体2 肺癌 脑转移瘤 

分 类 号：R734.2[医药卫生—肿瘤]