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目的观察重组人血管内皮抑制素(恩度)联合NP及GP方案治疗晚期非小细胞肺癌(NSCLC)的疗效和毒副反应。方法经病理学检查证实的68例ⅢB期和Ⅳ期NSCLC患者,包括鳞癌24例,腺癌32例,其他类型12例,均采用恩度加化疗联合治疗,其中联合NP方案41例,联合GP方案27例。恩度剂量为15 mg/次,加入生理盐水500 ml中静滴3～4 h,第1～14天;NP方案为长春瑞滨25 mg/m2静滴第1、5天,顺铂25mg/m2静滴第2～4天;GP方案为吉西他滨1000 mg/m2静滴第1、8天,顺铂25 mg/m2静滴第2～4天,均21 d为1个周期。所有患者至少完成2个周期,观察其近期疗效及毒副反应。结果 68例晚期NSCLC患者中,获得CR 1例,PR 26例(38.2%),SD 24例(35.2%),PD 17例(25.0%),总有效率为39.7%,临床受益率75.0%。发生Ⅲ～Ⅳ度中性粒细胞减少20例(29.4%),Ⅲ～Ⅳ度血小板减少8例(11.7%),Ⅲ～Ⅳ度呕吐15例(22.0%),全组无心律失常和出血发生。结论恩度联合NP及GP方案化疗治疗晚期NSCLC近期客观疗效较高,安全性好。
Objective To observe the efficacy and toxicity of recombinant human endostatin (Endostar) combined with NP and GP regimen in the treatment of advanced non-small cell lung cancer (NSCLC). Methods Sixty-eight NSCLC patients with Stage IIB and IV NSCLC confirmed by pathology, including 24 cases of squamous cell carcinoma, 32 cases of adenocarcinoma and 12 cases of other types, were treated with entecavir chemotherapy. Among them, 41 cases were combined with NP regimen 27 cases of GP program. Endostar dose of 15 mg / time, adding 500 ml of normal saline intravenous infusion of 3 ~ 4 h, 1 to 14 days; NP regimen vinorelbine 25 mg / m2 intravenous drip 1,5 days, cisplatin 25mg / m2 intravenously for 2 to 4 days; GP regimen for gemcitabine 1000 mg / m2 intravenous infusion on days 1 and 8, cisplatin 25 mg / m2 intravenous infusion 2 to 4 days, 21 d for a cycle. All patients completed at least 2 cycles to observe the recent efficacy and toxicity. Results Among 68 patients with advanced NSCLC, CR was found in 1 case, PR 26 cases (38.2%), SD 24 cases (35.2%) and PD 17 cases (25.0%) with a total effective rate of 39.7% and a clinical benefit rate of 75.0%. There were 20 cases (29.4%) with Ⅲ ~ Ⅳ neutropenia, 8 cases (11.7%) with Ⅲ ~ Ⅳ degree thrombocytopenia and 15 cases (22.0%) with Ⅲ ~ Ⅳ degree vomiting. All the patients had no arrhythmia and hemorrhage . Conclusion Endood combined with NP and GP regimen in the treatment of advanced NSCLC has high objective efficacy and good safety.