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目的观察周剂量内皮抑素改善乏氧联合放疗治疗非小细胞肺癌的临床疗效和不良反应。方法选择病理组织学确诊的非小细胞肺癌(Ⅰ-Ⅲ期)且乏氧阳性的患者50例,随机分为联合组(25例)和单放组(25例)。2组均采用调强放疗技术,靶区为原发灶及转移的淋巴结,不做预防性照射,总剂量DT 60 Gy/30次,共6周。联合组在放疗开始的1周内连续静脉滴注内皮抑素15 mg/d,与放疗同步进行,治疗结束后评价疗效和不良反应。结果在50例乏氧阳性的患者中,联合组总有效率(CR+PR)为80.0%,单放组为44.0%,差异有统计学意义(χ2=6.87,P<0.01);1年局部控制率分别为(78.9±8.4)%和(68.1±7.8)%,2年局部控制率分别为(63.6±7.2)%和(43.4±5.7)%,差异均有统计学意义(P<0.05);中位生存时间分别为(21.1±0.97)个月、(16.5±0.95)个月,差异有统计学意义(P<0.01);1年总生存率分别为(83.3±7.2)%和(76.6±9.3)%,2年总生存率分别为(46.3±2.4)%和(37.6±9.1)%,差异均无统计学意义(P>0.05)。结论周剂量内皮抑素改善乏氧联合放疗治疗非小细胞肺癌,具有良好的近期疗效和局部控制率,无明显不良反应,但1、2年总生存率没有明显提高。
Objective To observe the clinical efficacy and adverse reactions of weekly doses of endostatin to improve hypoxia combined with radiotherapy in the treatment of non-small cell lung cancer. Methods Fifty patients with pathologically confirmed non-small cell lung cancer (stage Ⅰ-Ⅲ) and hypoxia were randomly divided into combined group (n = 25) and single group (n = 25). Both groups received intensity-modulated radiation therapy. The target area was primary tumor and lymph node metastasis. Without preventive irradiation, the total dose of DT 60 Gy / 30 times for 6 weeks. The combined group received continuous intravenous infusion of endostatin 15 mg / d within one week after the start of radiotherapy, and was performed simultaneously with radiotherapy. After the treatment, the curative effect and adverse reactions were evaluated. Results Among the 50 cases of hypoxia-positive patients, the total effective rate (CR + PR) was 80.0% in the combination group and 44.0% in the single operation group (χ2 = 6.87, P <0.01) The control rates were (78.9 ± 8.4)% and (68.1 ± 7.8%) respectively, and the two-year local control rates were (63.6 ± 7.2)% and (43.4 ± 5.7)%, respectively ; The median survival time was (21.1 ± 0.97) months, (16.5 ± 0.95) months, the difference was statistically significant (P <0.01); the overall 1-year survival rates were (83.3 ± 7.2)% and ± 9.3%). The overall 2-year survival rates were (46.3 ± 2.4)% and (37.6 ± 9.1)%, respectively, with no significant difference (P> 0.05). Conclusions Weekly dosage of endostatin improves hypoxia combined with radiotherapy in the treatment of non-small cell lung cancer. It has good short-term curative effect and local control rate with no obvious adverse reactions. However, the overall survival rate did not increase significantly in 1 and 2 years.