重组人血管内皮抑制素联合含铂双药化疗老年晚期非小细胞肺癌患者的疗效和安全性  

Efficacy and safety of three days continuous intravenous pumping of recombinant human endostatin combined with platium-contained chemotherapeutic agents in patients with advanced non-small cell lung cancer aged 60 years or older

作　　者：沈华 郭锦慧 程弯弯 方申存 Shen Hua;Guo Jinhui;Cheng Wanwan;Fang Shencun(Department of Oncology,Affiliated Hospital of Yifu,Nanjing Medical University,Nanjing,211112,China;Department of Respiratory Medicine,Nanjing Chest Hospital,The Affiliated Brain Hospital of Nanjing Medical University,Nanjing,210029,China)

机构地区：[1]南京医科大学附属逸夫医院肿瘤内科,211112 [2]南京医科大学附属脑科医院(南京市胸科医院)呼吸内科,210029

出　　处：《中华老年医学杂志》2023年第1期30-34,共5页Chinese Journal of Geriatrics

基　　金：国家自然科学基金(81874230);江苏省自然科学基金(BK20211256);中华国际医学交流基金会-先声临床科研专项基金(Z-2014-06-2201)。

摘　　要：目的探讨恩度(重组人血管内皮抑制素)联合含铂双药化疗老年晚期非小细胞肺癌(NSCLC)患者的疗效和安全性。方法选取2019年1月至2021年6月93例老年晚期NSCLC患者作为研究对象,所有患者接受恩度3 d持续静脉泵入(210 mg连续泵入72 h)联合铂两药化疗。分别采用实体瘤疗效评价标准(RECIST)1.1版和不良反应事件评价标准(CTC AE)4.0版评估疗效和不良反应,根据随访数据进行生存分析。结果93例患者均可评价疗效,客观缓解率(ORR)和疾病控制率(DCR)分别为38.7%和78.5%,中位无进展生存期(PFS)和总生存期(OS)分别为6.8个月和16.5个月。多因素分析显示,肿瘤分期和TP53突变是影响PFS和OS的独立影响因素。治疗过程中与恩度3 d持续静脉泵注相关的不良反应包括心律失常2例(2.2%),心肌缺血1例(1.07%)和痰中带血1例(1.07%),且均为1~2级。结论恩度3 d持续静脉泵注联合含铂两药化疗治疗老年晚期NSCLC患者显示出较好的临床疗效和生存获益,且安全性良好,值得临床推广。Objective To investigate the efficacy and safety of recombinant human endostatin(Endostar)combined with platium-contained chemotherapeutic agents in advanced non-small cell lung cancer(NSCLC)patients over 60 years old.Methods 93 advanced NSCLC patients from January 2019 to June 2021 were selected as the research objects.The patients received three days of continuous intravenous infusion of Endostar(210 mg for 72 hours)combined with platinum-containing chemotherapy.The efficacy and toxicities were evaluated according to Response Evaluation Criteria in Solid Tumors(RECIST)version1.1 and National Cancer Institute Common Terminology Criteria for Adverse Events(NCI-CTCAE version 4.0),respectively.Follow-up data were obtained to perform the Kaplan-Meier survival analysis.Results In our study,the objective remission rate(ORR)and disease control rate(DCR)were 38.7%and 78.5%,respectively.The median progression-free survival(PFS)and overall survival(OS)were 6.8 months and 16.5 months,respectively.A Multivariate analysis showed that tumor staging and TP53 mutation were independent prognostic factors related to PFS and OS in advanced NSCLC patients.Adverse reactions related to Endostar during treatment included arrhythmia in 2 cases(2.2%),myocardial ischemia in 1 case(1.07%)and bloody sputum in 1 case(1.07%),all of which were Grade 1 or Grade 2.Conclusions The application of three days continuous intravenous infusion of Endostar combined with platium-contained chemotherapeutic agents is worthy to be recommended for clinical application in elderly patients with advanced NSCLC due to its high effective rate and survival advantage,as well as good safety.

关 键 词：癌 非小细胞肺 内皮 血管 内皮抑素类 治疗结果 

分 类 号：R734.2[医药卫生—肿瘤]