CAJ | 학술논문

目的观察重组人血管内皮抑制素联合同步放化疗治疗老年晚期非小细胞肺癌( NSCLC)患者的近期临床疗效、不良反应及耐受性.方法将39例经病理组织学或细胞学检查确诊的ⅢB～Ⅳ期NSCLC老年患者随机分成两组,实验组(19例)采用恩度联合同步放化疗治疗,对照组(20例)采用单纯同步放化疗治疗.采用调强放疗技术对肿瘤区域以及累及淋巴结区域进行放疗,总剂量DT 60 ～ 76 Gy/30 ～ 38次,共6～8周.化疗方案:多西他赛60 mg/m2第1天,顺铂30 mg/m2第1～3天,21 d为1个周期,共3～4个周期.重组人血管内皮抑素15 mg/d,第1～14天连续给药,与化疗同步进行.按照WHO标准评价近期疗效,参考KPS评分以及患者临床症状缓解情况评价患者的生活质量(QoL)；按照WHO抗癌药物不良反应分度标准评价不良反应.结果试验组和对照组的客观有效率(RR)分别为84.2％和50.0％(P＜0.05),临床受益率(CBR)分别为94.7％和70.0％(P＜0.05)；QoL改善稳定率为94.7％ (18/19)和90.0％(18/20) (P＞0.05);在血液学及非血液学不良反应主要有中性粒细胞减少、血小板减少、恶心、呕吐、乏力、心律失常、过敏,Ⅲ级以上不良反应发生率试验组和对照组差异无统计学意义；两组放射性食管炎和放射性肺炎的发生率分别为15.8％和10.0％(P＞0.05).结论重组人血管内皮抑素联合同步放化疗治疗老年晚期非小细胞肺癌,近期疗效有所提高,不良反应轻,易于接受.
목적 관찰중조인혈관내피억제소연합동보방화료치료노년만기비소세포폐암( NSCLC)환자적근기림상료효、불량반응급내수성.방법 장39례경병리조직학혹세포학검사학진적ⅢB～Ⅳ기NSCLC노년환자수궤분성량조,실험조(19례)채용은도연합동보방화료치료,대조조(20례)채용단순동보방화료치료.채용조강방료기술대종류구역이급루급림파결구역진행방료,총제량DT 60 ～ 76 Gy/30 ～ 38차,공6～8주.화료방안:다서타새60 mg/m2제1천,순박30 mg/m2제1～3천,21 d위1개주기,공3～4개주기.중조인혈관내피억소15 mg/d,제1～14천련속급약,여화료동보진행.안조WHO표준평개근기료효,삼고KPS평분이급환자림상증상완해정황평개환자적생활질량(QoL)；안조WHO항암약물불량반응분도표준평개불량반응.결과 시험조화대조조적객관유효솔(RR)분별위84.2％화50.0％(P＜0.05),림상수익솔(CBR)분별위94.7％화70.0％(P＜0.05)；QoL개선은정솔위94.7％ (18/19)화90.0％(18/20) (P＞0.05);재혈액학급비혈액학불량반응주요유중성립세포감소、혈소판감소、악심、구토、핍력、심률실상、과민,Ⅲ급이상불량반응발생솔시험조화대조조차이무통계학의의；량조방사성식관염화방사성폐염적발생솔분별위15.8％화10.0％(P＞0.05).결론 중조인혈관내피억소연합동보방화료치료노년만기비소세포폐암,근기료효유소제고,불량반응경,역우접수.
Objective To investigate the short -term efficacy,safety and toxicities and tolerance of concurrent chemoradiotherapy combined with endostar for advanced non - small cell lung cancer (NSCLC) in elderly patients.Methods A total of 39 patients were randomly divided into trial group (19 cases) and control group(20 cases).In the trial group,the patients received endostar combined with chemoradiotherapy concurrently.In the control group,the patients received only chemoradiotherapy concurrently.The patients were given intensity - modulated radiotherapy ( IMRT),the dose of primary tumors and involved lymph nodes was 60 - 76 Gy/30 - 38 times for 6 - 8 weeks.Concurrently they were administrated chemotherapy with or without endostar.Docetaxel 60 mg/m2 on day 1,DDP 30 mg/m2 on day 1 -3,the chemotherapy was repeated every 21 days as a cycle.The endostar was given 15 mg/d from day 1 - 14 simultaneously.The efficacy was evaluated according to RECIST criteria,quality of life (QOL) was evaluated by karnofsky,safety was evaluated according to NCICTC 3.0 version criteria.Results The overall response rate was 84.2％ in the trial group and 50.0％ in the control group respectively ( P ＜ 0.05).The clinical benefit rate was 94.7％ in the trial group and 70.0％ in control group ( P ＜ 0.05).The rates of improved and stabled QoL were 94.7％ and 90.0％ ( P ＞ 0.05),respectively.The main side effects were marrow suppression and gastrointestinal symptoms.The total incidence of side effects in treatment group was higher than that in control group,but there was no significanct difference existed ( P ＞ 0.05).Conclusions Endostar combined with concurrent chemoradiotherapy is effective, safe and well -tolerable in the treatment of advanced NSCLC in elderly patients.