CAJ | 학술논문

目的观察诱导化疗并三维适形放疗加重组人血管内皮抑制素治疗局部晚期非小细胞肺癌的疗效及毒副反应.方法将30例局部晚期NSCLC患者按随机数字表法分为两组,观察组15例:采用诱导化疗+重组人血管内皮抑制素+放疗,第1天,第8天,长春瑞滨25 mg/m2,第2～4天,顺铂30 mg/m2；第1～14天,重组人血管内皮抑制素注射液7.5 mg/m2,间隙7d后,重复使用,共2～4个疗程.对照组15例:采用诱导化疗+放疗,第1天,第8天,长春瑞滨25 mg/m2+第2～4天,顺铂30 mg/m2.放疗均采用三维适形放疗,处方剂量为60～ 68 Gy/30 ～34次.用WHO的标准评价疗效,比较有效率、毒副反应、中位无进展生存时间、1年生存率.结果观察组和对照组总有效率(CR+ PR)分别为66.7％和60.0％,(P＞0.05).观察组和对照组中位无进展生存时间分别是12个月和10个月.观察组和对照组中位生存时间分别是20个月和18个月.两组1年总生存率分别为80.0％(12/15)和73.3％(11/15),(P＞0.05).两组主要毒副反应为血液毒性、胃肠道反应、放射性食管炎和放射性肺炎,但差异无统计学意义(P＞0.05).结论重组人血管内皮抑制素联合诱导放化疗治疗局部晚期非小细胞肺癌在客观缓解率和总生存率方面均有所提高,毒副反应可以耐受,但差异无统计学意义,其结果有待进一步的随机多中心Ⅲ期临床研究.
목적 관찰유도화료병삼유괄형방료가중조인혈관내피억제소치료국부만기비소세포폐암적료효급독부반응.방법 장30례국부만기NSCLC환자안수궤수자표법분위량조,관찰조15례:채용유도화료+중조인혈관내피억제소+방료,제1천,제8천,장춘서빈25 mg/m2,제2～4천,순박30 mg/m2；제1～14천,중조인혈관내피억제소주사액7.5 mg/m2,간극7d후,중복사용,공2～4개료정.대조조15례:채용유도화료+방료,제1천,제8천,장춘서빈25 mg/m2+제2～4천,순박30 mg/m2.방료균채용삼유괄형방료,처방제량위60～ 68 Gy/30 ～34차.용WHO적표준평개료효,비교유효솔、독부반응、중위무진전생존시간、1년생존솔.결과 관찰조화대조조총유효솔(CR+ PR)분별위66.7％화60.0％,(P＞0.05).관찰조화대조조중위무진전생존시간분별시12개월화10개월.관찰조화대조조중위생존시간분별시20개월화18개월.량조1년총생존솔분별위80.0％(12/15)화73.3％(11/15),(P＞0.05).량조주요독부반응위혈액독성、위장도반응、방사성식관염화방사성폐염,단차이무통계학의의(P＞0.05).결론 중조인혈관내피억제소연합유도방화료치료국부만기비소세포폐암재객관완해솔화총생존솔방면균유소제고,독부반응가이내수,단차이무통계학의의,기결과유대진일보적수궤다중심Ⅲ기림상연구.
Objective To evaluate the efficacy and safety of induction chemotherapy and three-dimensional conformal radiation (3D-CRT) combined with endostar in the treatment of locally advanced non-small cell lung cancer (NSCLC).Methods Thirty patients with locally advanced NSCLC were enrolled and divided into observation group (15 cases) and control group (15 cases).In the observation group,the patients received induction chemotherapy and 3D-CRT combined with endostar.Chemotherapy:Vinorelbine 25mg/m2 on day 1 and 8,DDP 30mg/m2 on day 2 to 4.Endostar 7.5mg/m2 on day 1 to 14,which was used again after 7 days for 2 to 4 cycles.In the control group,the patients received induction chemotherapy and 3D-CRT at the same dosage.All patients were treated with 3D-CRT and the prescription dose was 60 ～ 68Gy per fraction.The responses were evaluated according to WHO criteria.The shortterm efficacy between the 2 groups was compared.Results The overall effective rate of the two groups were 66.7％ and 60.0％,respectively (P ＞ 0.05).The median progression-free survival time was 12 months in the observation group and 10 months in the control group.The median survival time was 20 months in the observation group and 18 months in the control group.The 1 year overall survival rate was 80.0％ in the observation group and 73.3％ in the control group(P ＞ 0.05).The main toxicities in the two groups were marrow suppression,gastrointestinal symptoms,acute radiation pneumonitis and acute radiation esophagitis.There was no significant difference between the two groups (P ＞ 0.05).Conclusions The combination of endostar with induction chemotherapy and 3D-CRT can improve the short-term efficacy rate of locally advanced NSCLC,the adverse events of which are tolerable,but the improvement is not significant in both groups.The result pending further randomized multi-center phase Ⅲ clinical study.