中华肿瘤杂志
中華腫瘤雜誌
중화종류잡지
CHINESE JOURNAL OF ONCOLOGY
2011年
12期
937-942
,共6页
重组人血管内皮抑制素%癌,非小细胞肺%循环活化血管内皮细胞%治疗周期%药物疗法
重組人血管內皮抑製素%癌,非小細胞肺%循環活化血管內皮細胞%治療週期%藥物療法
중조인혈관내피억제소%암,비소세포폐%순배활화혈관내피세포%치료주기%약물요법
Endostar%Carcinoma,non-small cell lung%Activated curculating endotheial cells%Therapeutic cycle%Drug therapy
目的 观察重组人血管内皮抑制素注射液联合TP或NP方案治疗晚期非小细胞肺癌(NSCLC)的疗效和安全性,并探讨与治疗周期的关系.方法 经病理组织学和(或)细胞学检查确诊的25例Ⅲb～Ⅳ期NSCLC患者,采用重组人血管内皮抑制素注射液联合NP方案治疗21例,联合TP方案治疗4例,21 d为1个周期,观察患者的近期疗效、疾病进展时间(TTP)、1年生存率、中位生存时间(OS)、生活质量变化和不良反应.采用流式细胞术检测治疗前、后外周血循环活化血管内皮细胞(aCECs)的数量,并评价其与疗效和治疗周期的关系.结果 全组25例患者均可进行疗效和安全性评价,其中部分缓解(PR)5例(20.0％),稳定(SD)14例(56.0％),进展(PD)6例(24.0％),客观有效率(RR)为20.0％,临床受益率(CBR)为76.0％,中位TTP为8个月,中位OS为19个月.短周期治疗(周期＜4个)14例,其中PR 2例,SD 6例,PD 6例,RR为14.3％；临床受益的8例患者的中位TTP为6个月,中位OS为18个月.长周期治疗(周期≥4个)11例,均为临床受益患者,其中PR3例,SD 8例,RR为27.3％,中位TTP为17个月,中位OS为26个月.短周期治疗临床受益者aCECs 平均上升(293±12)个/105,长周期治疗临床受益者平均下降( 243±181)个/105.治疗周期、TTP均与治疗前、后aCECS的数量变化呈正相关(r=0.970,P=0.001；r=0.829,P=0.042).全组生活质量改善12例,稳定10例,下降3例.全组患者的常见不良反应为血液和胃肠道不良反应,均不影响继续用药,长周期组和短周期组患者3～4度不良反应的发生率差异无统计学意义.结论 重组人血管内皮抑制素注射液联合TP或NP方案治疗晚期NSCLC能显著提高远期疗效,长周期治疗的患者TTP和OS均较短周期者延长,且长周期治疗并不增加不良反应的发生率.aCECs是较好的预测NSCLC疗效的指标.
目的 觀察重組人血管內皮抑製素註射液聯閤TP或NP方案治療晚期非小細胞肺癌(NSCLC)的療效和安全性,併探討與治療週期的關繫.方法 經病理組織學和(或)細胞學檢查確診的25例Ⅲb～Ⅳ期NSCLC患者,採用重組人血管內皮抑製素註射液聯閤NP方案治療21例,聯閤TP方案治療4例,21 d為1箇週期,觀察患者的近期療效、疾病進展時間(TTP)、1年生存率、中位生存時間(OS)、生活質量變化和不良反應.採用流式細胞術檢測治療前、後外週血循環活化血管內皮細胞(aCECs)的數量,併評價其與療效和治療週期的關繫.結果 全組25例患者均可進行療效和安全性評價,其中部分緩解(PR)5例(20.0％),穩定(SD)14例(56.0％),進展(PD)6例(24.0％),客觀有效率(RR)為20.0％,臨床受益率(CBR)為76.0％,中位TTP為8箇月,中位OS為19箇月.短週期治療(週期＜4箇)14例,其中PR 2例,SD 6例,PD 6例,RR為14.3％；臨床受益的8例患者的中位TTP為6箇月,中位OS為18箇月.長週期治療(週期≥4箇)11例,均為臨床受益患者,其中PR3例,SD 8例,RR為27.3％,中位TTP為17箇月,中位OS為26箇月.短週期治療臨床受益者aCECs 平均上升(293±12)箇/105,長週期治療臨床受益者平均下降( 243±181)箇/105.治療週期、TTP均與治療前、後aCECS的數量變化呈正相關(r=0.970,P=0.001；r=0.829,P=0.042).全組生活質量改善12例,穩定10例,下降3例.全組患者的常見不良反應為血液和胃腸道不良反應,均不影響繼續用藥,長週期組和短週期組患者3～4度不良反應的髮生率差異無統計學意義.結論 重組人血管內皮抑製素註射液聯閤TP或NP方案治療晚期NSCLC能顯著提高遠期療效,長週期治療的患者TTP和OS均較短週期者延長,且長週期治療併不增加不良反應的髮生率.aCECs是較好的預測NSCLC療效的指標.
목적 관찰중조인혈관내피억제소주사액연합TP혹NP방안치료만기비소세포폐암(NSCLC)적료효화안전성,병탐토여치료주기적관계.방법 경병리조직학화(혹)세포학검사학진적25례Ⅲb～Ⅳ기NSCLC환자,채용중조인혈관내피억제소주사액연합NP방안치료21례,연합TP방안치료4례,21 d위1개주기,관찰환자적근기료효、질병진전시간(TTP)、1년생존솔、중위생존시간(OS)、생활질량변화화불량반응.채용류식세포술검측치료전、후외주혈순배활화혈관내피세포(aCECs)적수량,병평개기여료효화치료주기적관계.결과 전조25례환자균가진행료효화안전성평개,기중부분완해(PR)5례(20.0％),은정(SD)14례(56.0％),진전(PD)6례(24.0％),객관유효솔(RR)위20.0％,림상수익솔(CBR)위76.0％,중위TTP위8개월,중위OS위19개월.단주기치료(주기＜4개)14례,기중PR 2례,SD 6례,PD 6례,RR위14.3％；림상수익적8례환자적중위TTP위6개월,중위OS위18개월.장주기치료(주기≥4개)11례,균위림상수익환자,기중PR3례,SD 8례,RR위27.3％,중위TTP위17개월,중위OS위26개월.단주기치료림상수익자aCECs 평균상승(293±12)개/105,장주기치료림상수익자평균하강( 243±181)개/105.치료주기、TTP균여치료전、후aCECS적수량변화정정상관(r=0.970,P=0.001；r=0.829,P=0.042).전조생활질량개선12례,은정10례,하강3례.전조환자적상견불량반응위혈액화위장도불량반응,균불영향계속용약,장주기조화단주기조환자3～4도불량반응적발생솔차이무통계학의의.결론 중조인혈관내피억제소주사액연합TP혹NP방안치료만기NSCLC능현저제고원기료효,장주기치료적환자TTP화OS균교단주기자연장,차장주기치료병불증가불량반응적발생솔.aCECs시교호적예측NSCLC료효적지표.
Objective To observe the correlation between long term efficacy/safety and treatment cycles of rh-endostatin (endostar) combined with TP (paclitaxel plus cisplatin/carboplatin ) or NP (navelbine plus cisplatin/carboplatin ) regimens in patients with advanced non-small cell lung cancer (NSCLC). Methods Twenty-five patients with advanced NSCLC confirmed by histopathology and/or cytology were enrolled in this study.Twenty-one patients underwent endostar combined with NP regimen and other four patients underwent endostar combined with TP regimen ( all repeated 21 days) treatment.The therapeutic effects,quality of life (QOL) and adverse effects were evaluated according to RECIST criteria,Karnofsky performance scores and WHO grading of adverse effects,respectively.Our intention was to make knowledge of the therapeutic effects,median time to progression,one-year survival rate,median overall survival and adverse reactions.The amount of circulating endothelial cells (CEC) in peripheral blood was measured by flow cytometry.Results All the 25 patients were evaluable for efficacy and safety.They were comprised of 5 cases of PR,14 cases of SD and 6 cases of PD.Of the 25 cases,RR was obtained in 5 cases (20.0％),CBR in 19 cases (76.0％),mTTP was 8 months and mOS was 19 months.Of the 14 patients with short treatment cycles ( ＜ 4),PR was obtained in 2 cases,SD in 6 cases and PD in 6 cases,RR was 14.3％.Of the 8 patients who obtained PR or SD,the median TTP was 6 months and median overall survival was 18 months.Of the 11 patients with long treatment cycles ( ≥4),PR was obtained in 3 cases,SD in 8 cases,RR was 27.3％,mTTP was 17 months and mOS was 26 months.After treatment,the amount of activated CECs was increased by (293 ± 12)/105 in patients with short treatment cycles,and decreased by (243 ± 181 )/105 in patients with long treatment cycles.A positive correlation was found between the changes of activated CECs after therapy,time to progression (TTP) and treatment cycles (r =0.970,P =0.001 ;r =0.829,P =0.042,respectively).The quality of life (QOL) was improved in 12 cases (48.0％),stable in 10 cases (40.0％),and decreased in 3 cases ( 12.0％ ).Grade 3 and 4 toxicities were mainly related with chemotherapeutics,including neutropenia in 4 cases ( 16.0％ ),vomiting in 3 cases ( 12.0％ )and arrhythmia in 1 case. No hypertension was observed. All the adverse reactions did not affect the following treatment,and there was no significant difference in incidence rate of grade 3 and 4 adverse events between the patients treated with long-term and short-term cycles.Conclusions Endostar combined with TP or NP regimen chemotherapy is effective and safe in the treatment of advanced NSCLC,especially in patients with long term treatment cycles which can effectively prolong TTP and reach long term survival,but not increase adverse events.The QOL of patients can be improved or remain stable.The changes of CECs may be used as a useful maker in predicting the efficacy of the combination treatment.
