沙利度胺在局部晚期非小细胞肺癌中抗血管生成作用的研究  

Study on anti-angiogenesis effect of thalidomide in locally advanced non-small cell lung cancer

作　　者：李爱科[1] 杜新生[1] 庞德全 王东娟[1] 李青山[1] 刘艳丽[1] 林萍萍[1] 朱翠敏[1] 

机构地区：[1]承德医学院附属医院肿瘤科,河北承德067000

出　　处：《检验医学与临床》2016年第24期3453-3455,共3页Laboratory Medicine and Clinic

基　　金：河北省承德市科学技术研究与发展计划资助项目(20142067)

摘　　要：目的探讨沙利度胺在治疗局部晚期非小细胞肺癌中的抗血管生成作用。方法以该院2012年10月至2014年1月收治的40例局部晚期非小细胞肺癌患者作为研究对象,分为对照组(单纯同步放、化疗)和治疗组(在对照组基础上联合沙利度胺),每组各20例。同步放疗剂量60Gy,6周30次;化疗方案为PC(紫杉醇45~50mg/m^2,1次/周+卡铂AUC=2,1次/周)/EP(顺铂50mg/m^2第1、8、29、36天+VP16 50mg/m^2第1~5天、第29~33天);沙利度胺每日200mg口服,第1天起持续10周。采用酶联免疫吸附试验检测全部患者0、6、10周血清血管内皮细胞生长因子(VEGF)水平。结果治疗后第10周,治疗组VEGF水平[(220.35±82.61)pg/mL]明显低于对照组[(292.76±152.06)pg/mL],差异有统计学意义(P<0.05)。治疗组近期疗效有效率(55%)高于对照组(40%),但差异无统计学意义(P>0.05)。治疗组睡眠改善、体质量增加、食欲增加和疼痛缓解情况均优于对照组,差异均有统计学意义(P<0.05)。对照组受益4例,治疗组受益17例,差异有统计学意义(χ~2=16.942,P=0.000)。对照组和治疗组治疗后在非血液学毒性和血液学毒性方面差异均无统计学意义(P>0.05)。结论沙利度胺联合EP/PC方案同步放、化疗可显著降低血清VEGF水平,提高局部晚期非小细胞肺癌患者临床受益率,且未增加毒副作用。Objective To investigate the anti-angiogenic effects of thalidomide in the treatment of locally advanced non-small cell lung cancer.Methods A total of 40 patients with locally advanced non-small cell lung cancer from October 2012 to January 2014 were enrolled in the study.The patients were divided into control group（concurrent chemotherapy alone）and treatment group（on the basis of the control group,combined with thalidomide）,20 cases in each group.Synchronous radiation dose 60Gy/6,30 times a week;chemotherapy for the PC（paclitaxel 45-50mg/m^2 weekly＋carboplatin AUC=2weekly）/EP（cisplatin 50mg/m^2 D1,8,29,36＋VP16 50mg/m^2 D1-5,D29-33）;Thalidomide daily 200 mg orally,first days for 10 weeks.Serum vascular endothelial growth factor（VEGF）levels in all patients were detected by enzyme-linked immunosorbent assay（ELISA）in 6,10 and 0weeks.Results At the 10 th week after treatment,the level of VEGF in the treatment group[（220.35±82.61）pg/mL]was significantly lower than that in the control group[（292.76±152.06）pg/mL]（P〉0.05）.The short-term curative effect of the treatment group（55%）was higher than that of the control group（40%）,but the difference was not statistically significant（P〈0.05）.In the treatment group,the sleep improvement,body weight increase,appetite increase and pain relief were better than the control group,and the differences were statistically significant（P〈0.05）.The control group benefited 4cases,the treatment group benefited 17 cases,the difference was statistically significant（χ^2=16.942,P=0.000）.There was no statistically significant difference between non-hematologic toxicity and hematologic toxicity in the control and treatment groups（P〉0.05）.Conclusion Thalidomide combined with EP/PC regimen concurrent chemoradiotherapy can significantly decrease the serum level of VEGF,improve the local advanced non small cell lung cancer patients with clinical benefit rate,without increasing side effects.

关 键 词：沙利度胺 局部晚期非小细胞肺癌 抗血管生成 血管内皮细胞生长因子 

分 类 号：R734.2[医药卫生—肿瘤]