重组人血管内皮抑制素联合含铂方案治疗晚期非小细胞肺癌的临床观察

目的 观察重组人血管内皮抑制素（恩度）联合含铂化疗方案治疗晚期非小细胞肺癌（NSCLC）的疗效及安全性。方法 选取69例晚期NSCLC患者，分为恩度联合化疗组（n=33）和单纯化疗组（n=36），两组化疗均采用含铂两药联合方案；恩度15mg加入生理盐水500ml静滴，每天1次，持续14天。观察两组的客观有效率（RR）、疾病控制率（DCR）、肿瘤进展时间（TTP）及不良反应。结果 治疗2个周期后恩度联合化疗组和单纯化疗组的RR分别为27.3％和19.4％（P＞0.05），DCR分别为90.9％和86.1％（P＞0.05）。治疗4个周期后，恩度联合化疗组和单纯化疗组的RR分别为13.0％和10.7％，差异无统计学意义（P＞0.05）；DCR分别为82.6％和50.0％，差异有统计学意义（P＜0.05）。恩度联合化疗组与单纯化疗组的中位TTP分别为6.5个月和4.7个月，差异有统计学意义（P=0.02）。两组主要不良反应为恶心呕吐、乏力及骨髓抑制，骨髓抑制以白细胞、中性粒细胞减少为主。恩度联合化疗组窦性心动过速发生率高于单纯化疗组（P＜0.05）。结论 恩度联合含铂方案化疗能显著提高晚期NSCLC的中位TTP及治疗4个周期的DCR，且安全性较好，具有较好的临床应用前景。

Clinical observation of rh-endostatin combined with platinum-based chemotherapy for advanced non-small cell lung cancer

Objective To investigate the efficacy and safety of rh-endostatin（endostar） combined with platinum-based chem- otherapy for advanced non-small cell lung cancer（NSCLC）. Methods Total of 69 advanced NSCLC inpatients were selected and di- vided into two groups： 33 patients treated with endostar plus platinum-based chemotherapy （combined group） and 36 patients treated with platinum-based chemotherapy alone （ monochemotherapy group）. The response rate （ RR）, disease control rate （ DCR）, time to progression（TTP）and side effects were evaluated. Results After two cycles of the treatment, the RR in combined group and mono- chemotherapy group were 27.3% and 19.4% , respectively（ P 〉 0. 05 ） , the DCR were 90.9% and 86. 1% （ P 〉 0. 05 ）. After four cy- cles of the treatment, the RR in combined group and monoehemotherapy group were 13.0% and 10. 7% （ P 〉 0. 05 ） , the DCR were 82. 6% and 50. 0% （P 〈0.05）. The median TTP were 6. 5 months and 4.7 months for combined group and monochemotherapy group, respectively. The main side effects of two groups were nausea/vomiting, fatigue, bone marrow depression and so on. Leukopenia and granulopenia were predominant in bone marrow depression. The incedence rate of nodal tachycardia in combined group was higher than that in monoehemotherapy group（ P 〈 0. 05 ）. Conclusion Endostar in combination with platinum-based chemotherapy for NSCLC pa- tients was effective, which can improve the median TTP and the DCR after four cycles of chemotherapy. It is worth further study.