CAJ | 학술논문

目的评价内皮抑素联合放疗治疗肺癌脑转移瘤的临床疗效及其获益人群.方法采用随机数字表分层随机方法,将80例肺癌脑转移瘤患者分为联合组和单放组,观察两组患者的近期有效率、总生存时间、脑水肿指数变化、不良反应；同时用免疫组化方法检测80例患者原发病灶中血管内皮生长因子受体2 (VEGFR2)蛋白表达情况,并对以上观察指标进行亚组分析.结果内皮抑素联合放疗治疗肺癌脑转移瘤,和单纯放疗相比,能够明显改善脑水肿(t=4.9,P=0.000),没有明显的毒副反应(P＞0.05)；在近期有效率方面,在总体人群(n=80)组中虽然有提高(90％ vs 75％,x2=3.11,P=0.07),但差异无统计学意义；然而在VEGFR2阳性亚组(93％ vs 67.7％,x2=6.31,P=0.012)分析中,差异有统计学意义.在总生存率(OS)方面,总人群组(P=0.35,95％ CI:0.25～1.30)和VEGFR2阳性亚组(P=0.109,95％ CI:0.40～ 1.34)中联合内皮抑素治疗,中位生存时间均未见获益.结论内皮抑素联合放疗同步治疗肺癌脑转移瘤,在VEGFR2蛋白高表达人群中,疗效显著,能够明显改善脑水肿,提高近期有效率,无明显的并发症和毒副反应.
목적 평개내피억소연합방료치료폐암뇌전이류적림상료효급기획익인군.방법 채용수궤수자표분층수궤방법,장80례폐암뇌전이류환자분위연합조화단방조,관찰량조환자적근기유효솔、총생존시간、뇌수종지수변화、불량반응；동시용면역조화방법검측80례환자원발병조중혈관내피생장인자수체2 (VEGFR2)단백표체정황,병대이상관찰지표진행아조분석.결과 내피억소연합방료치료폐암뇌전이류,화단순방료상비,능구명현개선뇌수종(t=4.9,P=0.000),몰유명현적독부반응(P＞0.05)；재근기유효솔방면,재총체인군(n=80)조중수연유제고(90％ vs 75％,x2=3.11,P=0.07),단차이무통계학의의；연이재VEGFR2양성아조(93％ vs 67.7％,x2=6.31,P=0.012)분석중,차이유통계학의의.재총생존솔(OS)방면,총인군조(P=0.35,95％ CI:0.25～1.30)화VEGFR2양성아조(P=0.109,95％ CI:0.40～ 1.34)중연합내피억소치료,중위생존시간균미견획익.결론 내피억소연합방료동보치료폐암뇌전이류,재VEGFR2단백고표체인군중,료효현저,능구명현개선뇌수종,제고근기유효솔,무명현적병발증화독부반응.
Objective To investigate the therapeutic effects of recombinant human endostatin (RHES) combined with radiotherapy on brain metastases (BM) of non-small cell lung cancer (NSCLC) and the patients suitable for this therapy.Methods Eighty patients with BM of NSCLC were randomly divided into RHES combined with radiotherapy group (combination group) and radiotherapy alone group (each group with 40 patients).The short-term effective rate,overall survival time,cerebral edema index and adverse reactions were observed and the expressions of vascular endothelial growth factor receptor 2 (VEGFR2) protein in primary lesions were detected with immunohistochemical method in all patients.Results Compared with radiotherapy alone group,brain edema was significantly relieved (t=4.9,P=0.000) and there were no marked adverse reactions in combination group.In short-term effective rate,there was no statistical significance in total population (n=80,90％ vs.75％,x2=3.11,P=0.07),but there was statistical significance in the patients with positive VEGFR2 (93％ vs.67.7％,x2=6.31,P=0.012).In overall survival time,there was no statistical significance in total population (n=80,P=0.35,95％ CI:0.25-1.30) or in the patients with positive VEGFR2 (P=0.109,95％ CI:0.40-1.34).Conclusion Compared with radiotherapy alone,RHES combined with radiotherapy can relieve brain edema in the patients with BM of NSCLC and obtain better short-term effective rate in the patients with positive VEGFR2.