CAJ | 학술논문

目的:观察重组人血管内皮抑制素恩度联合第3代含铂化疗方案治疗晚期非小细胞肺癌(non-small cell lung cancer, NSCLC)的疗效、中位无进展生存(progression-free survival, PFS)时间和不良反应.方法:55例晚期NSCLC患者接受恩度联合第3代含铂化疗方案治疗,化疗至少2个周期以上.观察指标包括PFS、总有效率(response rate, RR)、临床获益率(clinical benefit rate, CBR)和不良反应.结果:在51例可评价疗效的患者中,15例(29.4%)获得部分缓解,27例(52.9%)为疾病稳定,9例(17.6%)为疾病进展,无完全缓解患者;RR为29.4%(15/51),CBR为82.4%(42/51).所有55例患者的中位PFS为6.3个月.不同病理类型(P = 0.370)、初治与复治(P = 0.101)、不同化疗方案(P = 0.232)患者的近期疗效差异无统计学意义,PFS差异也无统计学意义.研究期间总的白细胞和血小板下降率分别为72.7%和54.5%,Ⅲ～Ⅳ度白细胞和血小板计数下降率分别为36.4%和21.8%.有4例患者因不良反应退出研究,其中1例患者因消化管出血而死亡,1例患者发生Ⅲ度血压升高而未得到控制,1例患者发生室上性心率失常,1例患者发生Ⅳ度肝功能异常.结论:恩度联合第3代含铂化疗方案治疗晚期NSCLC的近期CBR较高,PFS有所延长,不良反应尚能耐受.
목적:관찰중조인혈관내피억제소은도연합제3대함박화료방안치료만기비소세포폐암(non-small cell lung cancer, NSCLC)적료효、중위무진전생존(progression-free survival, PFS)시간화불량반응.방법:55례만기NSCLC환자접수은도연합제3대함박화료방안치료,화료지소2개주기이상.관찰지표포괄PFS、총유효솔(response rate, RR)、림상획익솔(clinical benefit rate, CBR)화불량반응.결과:재51례가평개료효적환자중,15례(29.4%)획득부분완해,27례(52.9%)위질병은정,9례(17.6%)위질병진전,무완전완해환자;RR위29.4%(15/51),CBR위82.4%(42/51).소유55례환자적중위PFS위6.3개월.불동병리류형(P = 0.370)、초치여복치(P = 0.101)、불동화료방안(P = 0.232)환자적근기료효차이무통계학의의,PFS차이야무통계학의의.연구기간총적백세포화혈소판하강솔분별위72.7%화54.5%,Ⅲ～Ⅳ도백세포화혈소판계수하강솔분별위36.4%화21.8%.유4례환자인불량반응퇴출연구,기중1례환자인소화관출혈이사망,1례환자발생Ⅲ도혈압승고이미득도공제,1례환자발생실상성심솔실상,1례환자발생Ⅳ도간공능이상.결론:은도연합제3대함박화료방안치료만기NSCLC적근기CBR교고,PFS유소연장,불량반응상능내수.
Objective:To observe the efficacy, median progression-free survival (PFS) and adverse reaction induced by rh-endostatin injection (Endostar) plus platin-based chemotherapy for advanced non-small cell lung cancer (NSCLC).Methods:Fifty five histologically or cytologically confirmed advanced NSCLC patients received Endostar combined with platin-based chemotherapy for more than 2 cycles. The evaluated parameters included PFS, response rate (RR), clinical benefit rate (CBR) and adverse reaction. Results:Of the 51 patients who can be evaluated for response, 15 (29.4%) achieved partial response (PR), 27 (52.9%) had stable disease (SD), 9 (17.6%) had progressive disease(PD), no patient had complete response(CR). The overall RR was 29.4% (15/51) and CBR was 82.4% (42/51). The median PFS was 6.3 months. There were no significant differences in the short-term efficacy and PFS between the patients who had different pathological features (P=0.037), those had naive or relapsed diseases (P=0.101), or those received different chemotherapeutic regimens (P=0.232). The total white cells and platelets decreased by 72.7% and 54.5%, respectively. The frequency of grade Ⅲ or Ⅳ neutropenia and thrombocytopenia were 36.4% (20 caces) and 21.8% (12 cases), respectively. Four patients stopped the therapy for adverse reaction. One died of gastrointestinal hemorrhage; one had uncontrolled grade Ⅲ hypertension; one had superventricular arrhythmia; one had grade Ⅳ hepatic dysfunction. Conclusion:The combination of Endostar and platin-based chemotherapy increased the CBR and prolonged the PFS of the patients with advanced NSCLC. The toxicities were tolerable.