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目的观察贝伐珠单抗注射液辅助治疗老年局部晚期非小细胞肺癌(NSCLC)患者的临床疗效及机制。方法 58例老年局部晚期NSCLC患者随机分为试验组29例与对照组29例。对照组用放疗联合同步化疗,化疗方案:第1,8,15天,静脉滴注紫杉醇注射液60 mg·m-2,第1,15天,静脉滴注卡铂AUC2~4 mg·m-2,每个周期21 d,同步化疗2个周期,放疗结束后继续化疗2个周期;试验组在对照组治疗的基础上,第1天,静脉滴注贝伐珠单抗7.5 mg·kg-1,每个周期21 d,辅助化疗4个周期。比较2组患者的总有效率、生活质量改善情况、血管内皮生长因子(VEGF)、碱性纤维细胞生长因子(b FGF)水平变化及药物不良反应发生情况。结果试验组总有效率为75.86%(22/29例),对照组为62.07%(18/29例),差异有统计学意义(P<0.05)。试验组生活质量提高率为58.62%(17/29例),对照组为34.48%(10/29例,P<0.05)。试验组VEGF为(258.81±74.41)ng·L~(-1),b FGF为(13.02±8.72)ng·L~(-1);对照组VEGF为(310.34±100.24)ng·L~(-1),b FGF为(19.81±10.73)ng·L~(-1)(P<0.05)。2组药物不良反应主要表现为肺、食管、骨髓、皮肤等药物不良反应,2组药物不良反应发生率差异无统计学意义(P>0.05)。结论贝伐珠单抗辅助治疗能有效降低患者血清VEGF和b FGF水平,在改善患者生活质量方面有更加积极的作用。
Objective To observe the clinical efficacy and mechanism of bevacizumab injection in the treatment of elderly patients with locally advanced non-small cell lung cancer (NSCLC). Methods Fifty-eight elderly patients with locally advanced NSCLC were randomly divided into experimental group (n = 29) and control group (n = 29). In the control group, radiotherapy combined with concurrent chemotherapy was used. On the 1st, 8th and 15th day, the paclitaxel injection 60 mg · m-2 was intravenously administered. On the 1st and 15th days, the carboplatin AUC2 ~ 4 mg · m- 2, each cycle 21 d, 2 cycles of concurrent chemotherapy, chemotherapy after the end of 2 cycles of chemotherapy; experimental group in the control group based on the treatment, on the first day, intravenous infusion of bevacizumab 7.5 mg · kg- 1, each cycle 21 d, adjuvant chemotherapy 4 cycles. The total effective rate, quality of life, vascular endothelial growth factor (VEGF), basic fibroblast growth factor (b FGF) level and adverse drug reactions in the two groups were compared. Results The total effective rate was 75.86% (22/29 cases) in the trial group and 62.07% (18/29 cases) in the control group, the difference was statistically significant (P <0.05). The improvement rate of the quality of life in the experimental group was 58.62% (17/29 cases) and that in the control group was 34.48% (10/29 cases, P <0.05). In the experimental group, VEGF was (258.81 ± 74.41) ng · L -1, b FGF was (13.02 ± 8.72) ng · L -1), while VEGF in the control group was (310.34 ± 100.24) ng · L -1 1), b FGF was (19.81 ± 10.73) ng · L -1 (P <0.05). There were no adverse reactions in the two groups (P> 0.05). The main adverse reactions of the two groups were side effects of drugs such as lung, esophagus, bone marrow and skin. Conclusion Bevacizumab adjuvant therapy can effectively reduce the serum levels of VEGF and b FGF in patients and has a more positive effect on improving the quality of life of patients.