重组人血管内皮抑制素窗口期联合化疗治疗晚期大肠癌的临床疗效

目的:观察重组人血管内皮抑制素(恩度)窗口期联合化疗治疗晚期大肠癌的临床疗效。方法:选取2014年6月至2018年6月于贵州省肿瘤医院就诊的不可手术的晚期大肠癌患者120例,随机分为重组人血管内皮抑制素窗口期联合化疗组(试验组)及重组人血管内皮抑制素常规方案联合化疗组(对照组)各60例。试验组方案:重组人血管内皮抑制素15 mg/d,d1~d7,间歇7天重复,用药14天为1个周期,化疗于每周期使用重组人血管内皮抑制素第5天(窗口期)开始;对照组方案:重组人血管内皮抑制素15 mg/d,d1~d14,间歇7天重复,21天为1个周期,化疗于重组人血管内皮抑制素治疗第1天开始;两组均采用m FOLFOX6或FOLFIRI方案化疗。对比分析两组的临床疗效。结果:1)试验组与对照组客观有效率(objective response rate,ORR)分别为25.0%和18.3%,疾病控制率(disease control rate,DCR)分别为80.0%和73.3%,差异均无统计学意义(P=0.375,P=0.388);2)试验组与对照组1、2、3年生存率分别为(69.6%vs.62.5%)(39.7%vs.21.3%)(26.8%vs.13.3%),中位生存时间为22个月(95%CI:16.817~27.183)vs.16个月(95%CI:11.890~20.110),试验组较对照组生存率提高、生存时间延长,差异具有统计学意义(P=0.033)。3)试验组与对照组中位疾病进展时间(time to progression,TTP)分别为9、8个月,差异无统计学意义(P>0.05)。结论:重组人血管内皮抑制素窗口期联合化疗较常规应用方案联合化疗提高晚期大肠癌患者的1、2、3年生存率,延长中位生存时间。

Treatment of advanced colorectal cancer with chemotherapy and recombinant human endostatin in the window period

  Objective  To observe the effect of recombinant human endostatin (endostar) combined with chemotherapy on advanced colorectal cancer.  Methods  A total of 120 inoperable patients with advanced colorectal cancer who were admitted to the Guizhou Cancer Hospital from June 2014 to June 2018 were selected. The patients were divided into two groups. Sixty cases were allocated to the test group and received endostar of 15 mg/d, d1-d7, which was repeated after 7 and 14 days. Chemotherapy was initiated on the 5th day of endostar (endostar window period). Sixty patients were allocated to the control group and received endostar of 15 mg/d, d1-d14, which was repeated after 7 and 21 days. Chemotherapy was initiated on the 1st day of endostar. The chemotherapy regimen used was mFOLFOX6 or FOLFIRI.  Results  The objective response rate (ORR) of the test and control groups was 25.0%, and 18.3%, respectively, and the disease control rate (DCR) was 80.0% and 73.3%, respectively. The difference was not significant (P=0.375, P=0.388). The 1-year survival rate of the test group and the control group was 69.6% and 62.5%, respectively, while the 2-year survival rate was 39.7% and 21.3%, respectively. Moreover, the 3-year survival rate was 26.8% and 13.3%, respectively, and the median survival time was 22 months (95% CI 16.817-27.183) and 16 months (95% CI 11.890-20.110), respectively. In contrast to the control group, the survival rate increased and the survival time was prolonged in the test group (P=0.033). The progression time (TTP) of median disease in the test and control groups was 9 months and 8 months, respectively. This was not statistically significant (P>0.05).  Conclusion  This study found that chemotherapy with recombinant human endostatin in the window stage can enhance the 1, 2, and 3-year survival rate of patients with advanced colorectal cancer, as well as prolong the median survival time.