重组人血管内皮抑素联合卡铂方案对非小细胞肺癌术后近期疗效及血标志物的影响

目的 探讨重组人血管内皮抑索(恩度,EndostarTM)联合多西紫杉醇和卡铂(TP)方案术后辅助治疗非小细胞肺癌(NSCLC)的疗效及对外周血标志物的影响.方法 采用重组人血管内皮抑素联合TP方案(治疗组)和单用TP方案(对照组)治疗Ⅰb-Ⅲa期的NSCLC术后患者各18例,观察近期疗效、并检测治疗前后外周血循环血管内皮细胞(CEC)数量及肿瘤标志物CEA、NSE、CYFR21-1的水平.结果 外周血CEC及CEA、NSE、CYFR21-1治疗后均有下降,第4周期治疗后治疗组的CEC和NSE与对照组比较差异有统计学意义(P=0.016和P=0.013).治疗组无病生存时间延长,但尚无统计学意义.复发、转移患者CEC明显升高,经治疗病情好转后下降.结论 重组人血管内皮抑素联合TP方案术后辅助治疗NSCLC较单纯化疗显示近期疗效上的优势、长期生存结果值得期待.CEC可能是一个较好的预测疗效的指标.

rh-endostatin in combination with docetaxel and carboplatin as adjuvant treatment for non-small lung cancer

Objective To evaluate the efficacy of EndostarTM (rh-endostatin,YH-16) combined with docetaxel and carboplatin (TP)regimen for the adjuvant treatment of non-small lung cancer (NSCLC) and its impact on circulating blood markers. Methods 36 patients with stage Ⅰ b-Ⅲ a postoperative NSCLC, were randomly divided into the treatment group, EndostarTM plus TP regimen, and the control group, TP regimen only, respectively. DFS and toxicities of patients were observed. The numbers of CEC and the levels of tumor marker CEA, NSE and CYFR21-1 were measured. Results The numbers of CEC and the levels of CEA, NSE and CYFR21-1 decreased after treatment. There were significant differences in GEC and NSE between treatment group and control group after four cycles of treatment, respectively (P = 0.016 and 0.013). Disease-free survival time (DFS) was longer in treatment group than control group but without significant difference. CEC was significantly increased in recurrent and metastasis cases and decreased after effective treatment Conclusion EndostarTM combined with TP regimen seem to be superior to TP alone in some short term index for the treatment of postoperative NSCLC even though long-term survival is still anticipated. CEC, as a biomarker, may be useful in predicting the efficacy of the such synergistic treatment.