重组人血管内皮抑素联合培美曲塞和卡铂方案一线治疗高龄晚期肺腺癌患者的临床观察

目的探讨重组人血管内皮抑素（恩度）联合培美曲塞和卡铂（PC）方案一线治疗年龄大于70岁的晚期肺腺癌患者的疗效和不良反应。方法回顾性分析41例经病理组织学证实的高龄肺腺癌患者，给予重组人血管内皮抑素（恩度）联合培美曲塞和卡铂（Pc）方案化疗。恩度15mg／d静滴，第1-14天；培美曲塞500mg／m2，第1天；卡铂取AUC为5，第1天，21天为1个周期，记录治疗的有效率（RR）、无疾病进展生存时间（PFS）、总生存期（OS）和不良反应。按实体瘤疗效评价标准评价治疗效果。结果41例均可评价疗效，完全缓解（CR）2例，部分缓解（PR）13例，稳定（SD）15例，进展（PD）11例。有效率（CR＋PR）为36．6％，疾病控制率（CR＋PR＋SD）为73．2％，中位PFS为7．9个月，中位OS为13个月。主要不良反应为Ⅰ-Ⅱ级的胃肠道反应和骨髓抑制，Ⅲ～Ⅳ级不良反应包括中性粒细胞缺乏4例，无化疗相关性死亡。结论重组人血管内皮抑素联合PC方案一线治疗高龄晚期肺腺癌患者疗效较好，不良反应可以耐受。

Clinical observation of rh-endostatin combined with pemetrexed and carboplatin in the treatment of elder advanced lung adenocarcinoma

Objective To retrospectively analysis the safety and efficacy of rh-endostatin combined with pemetrexed and carboplatin in the treatment of elder advanced lung adenocarcinoma.Methods41 patients with histologically confirmed lung adenocarcinoma were treated by rh-endostatin combined with pemetrexed and carboplatin were selected.All of the patients were prescribed pemetrexed 500mg/m~2and carboplatin AUC 5 intravenously on day 1,15mg rh-endostatin was slowly intravenously dropped from day 1 to day 14,3weeks as a cycle,and 2-6 cycles at least.The primary endpoint was response rate(RR),and the secondary endpoint was progression-free survival(PFS),overall survival(OS),and adverse events(AEs).Results In the study,there were 2 cases CR,13 cases PR,15 cases SD and 11 cases PD after treatment.The objective response rate was 36.6% and disease contral rate was 73.2%.The median progression-free survival and overall survival were 8.9 months and 15 months.The major toxicities were myelosuppression,gastrointestinal symptoms,most in grade Ⅰ-Ⅱ,mainly caused by side effects of chemotherapy.Conclusions Rh-endostatin combined with pemetrexed and carboplatin in the treatment of elder advanced lung adenocarcinoma is safe and effective,and merits further study.