目的 探讨重组人血管内皮抑素联合长春瑞滨、顺铂治疗晚期非小细胞肺癌的近期临床疗效及远期预后效果。方法 采用随机数字表法将福建省肿瘤医院肿瘤科2010-2013年收治的75例晚期非小细胞肺癌患者分为研究组37例和对照组38例,两组均采用长春瑞滨+顺铂进行治疗,研究组加用重组人血管内皮抑素治疗,对两组患者的近期疗效、远期预后进行随访观察比较。结果 研究组有一例ⅢB期患者达到完全缓解(CR)效果,对照组无患者达到CR效果。研究组患者的缓解率达到54.05%,显著高于对照组的31.58%(P>0.05);研究组的受益率为78.38%,高于对照组的68.42%,但差异不具有统计学意义。治疗后研究组的生活质量调查表(QOL)、美国东部肿瘤协作组织(ECOG)评分较治疗前均显著改善(P<0.05),同时优于治疗后的对照组,差异具有统计学意义(P<0.05)。研究组患者的白细胞减少率为51.35%、血小板减少率为10.81%,均显著的低于对照组白细胞减少率73.68%、血小板减少率31.58%,差异均具有统计学意义(P<0.05)。两组患者的胃肠道反应、肝功能损害毒副反应发生率比较差异不具有统计学意义(P>0.05)。研究组患者经过1年随访,失访1例患者,存活20例患者,存活率为54.05%;对照组患者经过1年随访,1例患者失访,存活14例患者,存活率为36.84%,研究组高于对照组,但差异不具有统计学意义;研究组的1年中位生存时间为305 d、对照组为270 d,研究组的1年中位生存时间显著长于对照组患者,差异具有统计学意义(P<0.05)。结论 重组人血管内皮抑素联合长春瑞滨、顺铂治疗晚期非小细胞肺癌可以提高患者的缓解率、降低不良反应,延长患者的生存时间。

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.

吴阶平医学基金会临床科研专项资助基金(320.6750.14283)