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每周重组人血管内皮抑制素联合放疗治疗非小细胞肺癌的初步临床研究

Preliminary clinical study of weekly recombinant human endostatin as a hypoxic tumour cell radiosensitiser combined with radiotherapy in the treatment of NSCLC.

机构信息

Department of Oncology, Lianyungang First People's Hospital, Lianyungang 222002, China.

出版信息

Clin Transl Oncol. 2012 Jun;14(6):465-70. doi: 10.1007/s12094-012-0825-z.

Abstract

OBJECTIVE

To investigate the clinical effects and adverse effects of weekly recombinant human endostatin (RHES) as a hypoxic tumour cell radiosensitiser combined with radiotherapy in the treatment of non-small-cell lung cancer (NSCLC).

METHODS

Fifty hypoxia-positive cases of pathology-diagnosed NSCLC (stage I-III) were randomly divided into a RHES+radiotherapy group (25 cases) and a radiotherapy alone group (25 cases). Intensity-modulated radiotherapy (IMRT) with a total dose of 60 Gy/30F/6W was adopted in the two groups. Target area included primary foci and metastatic lymph nodes. In the RHES+radiotherapy group, RHES (15 mg/day) was intravenously given during the first week. The therapeutic effects and adverse reactions were evaluated after treatment.

RESULTS

In the RHES+radiotherapy and radiotherapy alone groups, the total effective rates (CR+PR) were 80% and 44% (χ(2)=6.87, p=0.009), respectively. The one-year and two-year local control rates were (78.9±8.4)% and (68.1±7.8)% (p=0.027), and (63.6±7.2)% and (43.4±5.7)% (p=0.022), respectively. The median progression-free survival was (21.1±0.97) and (16.5±0.95) months, respectively. The one-year and two-year overall survival rates were (83.3±7.2)% and (76.6±9.3)% (p=0.247), and (46.3±2.4)% and (37.6±9.1)% (p=0.218), respectively.

CONCLUSION

RHES combined with radiotherapy within the first week has better short-term therapeutic effects and local control rate, and no severe adverse reactions in treatment of NSCLC. However, it failed to significantly improve the one-year and two-year overall survival rates.

摘要

目的

观察重组人血管内皮抑制素(rhES)联合放射治疗对非小细胞肺癌(NSCLC)患者的近期疗效及不良反应。

方法

50 例 NSCLC 患者经病理证实存在乏氧,按随机数字表法分为rhES+放疗组(25 例)和单纯放疗组(25 例)。两组均行调强放疗(IMRT),总剂量 60 Gy/30 次/6 周,照射野包括原发病灶和转移淋巴结。rhES+放疗组在放疗第 1 周给予 rhES 15 mg/d 静脉滴注。评价两组患者的近期疗效和不良反应。

结果

rhES+放疗组和单纯放疗组总有效率(CR+PR)分别为 80%和 44%(χ(2)=6.87,p=0.009),1 年和 2 年局部控制率分别为(78.9±8.4)%和(68.1±7.8)%(p=0.027)、(63.6±7.2)%和(43.4±5.7)%(p=0.022),中位无进展生存时间分别为(21.1±0.97)和(16.5±0.95)个月,1 年和 2 年总生存率分别为(83.3±7.2)%和(76.6±9.3)%(p=0.247)、(46.3±2.4)%和(37.6±9.1)%(p=0.218)。

结论

rhES 联合放疗能提高 NSCLC 患者的近期疗效和局部控制率,且不良反应轻,但不能显著提高 1 年和 2 年总生存率。

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