Jiang Xiao-dong, Ding Man-hua, Qiao Yun, Liu Yi, Liu Liang
Department of Radiation Oncology, Lianyungang First People's Hospital, Lianyungang, China.
Department of Radiation Oncology, Lianyungang First People's Hospital, Lianyungang, China.
Clin Lung Cancer. 2014 Mar;15(2):e23-9. doi: 10.1016/j.cllc.2013.11.012. Epub 2013 Nov 20.
Brain metastases are often accompanied by edema. Endostatin therapy can prevent tumor tissue edema. Therefore, we investigated the therapeutic effects of endostatin combined with radiotherapy in the treatment of brain metastases of non-small cell lung cancer (NSCLC) and assessed the relations between the effect and vascular endothelial growth factor receptor 2 (VEGFR2) expression.
Eighty patients with brain metastases of NSCLC were randomly divided into a combination therapy group and a radiotherapy-alone group, each group with 40 patients. The short-term effective rate, overall survival time, cerebral edema index, and adverse reactions were observed, and the expressions of VEGFR2 protein and KDR gene in primary lesions were detected via immunohistochemical methods and fluorescence in-situ hybridization (FISH) in all patients.
Compared with the radiotherapy-alone group, brain edema was significantly relieved (P = .003) and there were no marked adverse reactions in the combination therapy group. Regarding the short-term effective rate, there was no statistical significance in the total population (n = 80, 90% vs. 75%, P = .07), but there was statistical significance in cases of positive VEGFR2 (93% vs. 67.7%, P = .012) or positive KDR gene (94.4% vs. 47.3%, P = .002) in both groups. For overall survival time, there was no statistical significance in total population (n = 80, P = .35), positive VEGFR2 patients (P = .109), and positive KDR gene patients (P = .147).
Compared with radiotherapy alone, endostatin combined with radiotherapy can relieve brain edema in patients with brain metastases of NSCLC and can obtain a better short-term effective rate in patients with positive VEGFR2 or positive KDR gene, but endostatin therapy does not significantly improve overall survival time.
脑转移瘤常伴有水肿。内皮抑素治疗可预防肿瘤组织水肿。因此，我们研究了内皮抑素联合放疗治疗非小细胞肺癌（NSCLC）脑转移瘤的疗效，并评估了疗效与血管内皮生长因子受体2（VEGFR2）表达之间的关系。
80例NSCLC脑转移瘤患者随机分为联合治疗组和单纯放疗组，每组40例。观察短期有效率、总生存时间、脑水肿指数及不良反应，并采用免疫组化法和荧光原位杂交（FISH）检测所有患者原发灶中VEGFR2蛋白和KDR基因的表达。
与单纯放疗组相比，联合治疗组脑水肿明显减轻（P = 0.003），且无明显不良反应。在短期有效率方面，总体人群（n = 80，90%对75%，P = 0.07）无统计学意义，但两组中VEGFR2阳性（93%对67.7%，P = 0.012）或KDR基因阳性（94.4%对47.3%，P = 0.002）的病例有统计学意义。对于总生存时间，总体人群（n = 80，P = 0.35）、VEGFR2阳性患者（P = 0.109）和KDR基因阳性患者（P = 0.147）均无统计学意义。
与单纯放疗相比，内皮抑素联合放疗可减轻NSCLC脑转移瘤患者的脑水肿，且在VEGFR2阳性或KDR基因阳性患者中可获得更好的短期有效率，但内皮抑素治疗并未显著改善总生存时间。
