目的 探討重組人血管內(nèi)皮抑素聯(lián)合長春瑞濱、順鉑治療晚期非小細胞肺癌的近期臨床療效及遠期預(yù)后效果。方法 采用隨機數(shù)字表法將福建省腫瘤醫(yī)院腫瘤科2010-2013年收治的75例晚期非小細胞肺癌患者分為研究組37例和對照組38例,兩組均采用長春瑞濱+順鉑進行治療,研究組加用重組人血管內(nèi)皮抑素治療,對兩組患者的近期療效、遠期預(yù)后進行隨訪觀察比較。結(jié)果 研究組有一例ⅢB期患者達到完全緩解(CR)效果,對照組無患者達到CR效果。研究組患者的緩解率達到54.05%,顯著高于對照組的31.58%(P>0.05);研究組的受益率為78.38%,高于對照組的68.42%,但差異不具有統(tǒng)計學(xué)意義。治療后研究組的生活質(zhì)量調(diào)查表(QOL)、美國東部腫瘤協(xié)作組織(ECOG)評分較治療前均顯著改善(P<0.05),同時優(yōu)于治療后的對照組,差異具有統(tǒng)計學(xué)意義(P<0.05)。研究組患者的白細胞減少率為51.35%、血小板減少率為10.81%,均顯著的低于對照組白細胞減少率73.68%、血小板減少率31.58%,差異均具有統(tǒng)計學(xué)意義(P<0.05)。兩組患者的胃腸道反應(yīng)、肝功能損害毒副反應(yīng)發(fā)生率比較差異不具有統(tǒng)計學(xué)意義(P>0.05)。研究組患者經(jīng)過1年隨訪,失訪1例患者,存活20例患者,存活率為54.05%;對照組患者經(jīng)過1年隨訪,1例患者失訪,存活14例患者,存活率為36.84%,研究組高于對照組,但差異不具有統(tǒng)計學(xué)意義;研究組的1年中位生存時間為305 d、對照組為270 d,研究組的1年中位生存時間顯著長于對照組患者,差異具有統(tǒng)計學(xué)意義(P<0.05)。結(jié)論 重組人血管內(nèi)皮抑素聯(lián)合長春瑞濱、順鉑治療晚期非小細胞肺癌可以提高患者的緩解率、降低不良反應(yīng),延長患者的生存時間。

Objective To study the clinical efficacy and long-term prognosis effect of recombinant human endostatin combined with Changchun vinorelbine and cisplatin in the treatment of advanced non small cell lung cancer. Methods Using random number table method, 75 patients with advanced tumor in Fujian Provincial Tumor Hospital hospital from 2010 to 2013 were in patients with non small cell lung cancer were divided into study group (37 cases) and control group (38 cases), the patients in two groups were treated with vinorelbine plus cisplatin in Changchun for treatment, the study group treated with recombinant human endostatin, on the long-term prognosis of curative effect in the near future, two patients were followed up for comparison. Results In study group, there was one case of phase IIIB patient reached the CR effect, the control group had no effect in patients with CR. In the study group, the remission rate of 54.05% was significantly higher than that of the control group 31.58%, the benefit rate of study group was 78.38% higher than 68.42% in the control group but the difference was not statistically significant. The QOL after treatment in research group and ECOG score before treatment were significantly improved (P<0.05), while higher than the control group after treatment (P<0.05). The rate of white blood cells reduction was 51.35%, and the rate of platelet reduction was 10.81%, which were significantly lower than those in the control group (73.68% and 31.58%), with statistically significant differences (P<0.05). Gastrointestinal reaction and liver function of two groups of patients with damage and adverse reaction was not statistically significant differences. Patients in the study group after 1 year of follow-up, 1 patients were lost to follow-up, 20 patients survived, the survival rate was 54.05%, the control group of patients after 1 year of follow-up, 1 patients were lost to follow-up, 14 patients survived, the survival rate was 36.84%, the study group was higher than the control group but the difference was not statistically significant; the study group of 1 year, the median survival time was 305 d, the control group was 270 d, the research group 1 year survival time was significantly longer than the patients in the control group, with statistical significance (P<0.05). Conclusion Recombinant human endostatin combined with Changchun vinorelbine and cisplatin in the treatment of advanced non small cell lung cancer can improve the remission rate of patients, reduce the adverse reaction, and prolong the survival time of patients.

吳階平醫(yī)學(xué)基金會臨床科研專項資助基金(320.6750.14283)