摘要
目的 探讨环磷酰胺节拍化疗联合重组人血管内皮抑制素用于非小细胞肺腺癌维持治疗的近期和远期疗效.方法 选取2011年1月至2013年1月经病理确诊的86例晚期非小细胞肺腺癌患者,在接受最大耐受剂量环磷酰胺化疗4个周期后,按随机数字表法分为观察组和对照组.观察组予以环磷酰胺节拍化疗联合重组人血管内皮抑制素治疗,对照组仅予以环磷酰胺节拍化疗治疗,对比2组患者维持治疗6周后的外周血T细胞亚群、细胞因子水平,近期和远期临床疗效及不良反应.结果 观察组维持治疗前和维持治疗6周后血清可溶性Fas （sFas）、干扰素γ、肿瘤坏死因子α（TNF-α）、白细胞介素（IL）-2比较分别为（6 102 ±205） ng/L比（4 892±195） ng/L、（7.8±2.8）％比（15.2±2.4）％、（6.6±2.1）％比（7.7±2.2）％、（9.2±1.1）％比（11.3±1.7）％,对照组维持治疗前和维持治疗6周后sFas,干扰素γ,TNF-α,IL-2比较分别为（6 096±199） ng/L比（5 816±201）ng/L、（7.8±3.1）％比（5.5±2.4）％、（6.6±1.5）％比（7.4±0.5）％、（9.2±1.4）％比（10.6±1.8）％,2组患者治疗6周后sFas水平明显低于治疗前,干扰素γ,TNF-α,IL-2水平均明显高于治疗前（P＜0.05）;观察组治疗6周后sFas水平均明显低于对照组,干扰素γ、TNF-α、IL-2水平明显高于对照组（P＜0.05）.观察组治疗6周后有效率明显高于对照组[35.7％ （15/42）比13.6％ （6/44）,P＜0.05];2组无进展生存期和总生存期差异无统计学意义（P＞0.05）.2组患者不良反应发生率差异无统计学意义（P=0.465）.结论 采用环磷酰胺节拍化疗联合重组人血管内皮抑制素用于非小细胞肺腺癌维持治疗,可明显提高患者免疫力,改善临床疗效.
Objective To analyze the short-term and long-term efficiency of cyclophosphamide （CPA） metronomic chemotherapy （MET） combined with recombinant human endostatin （Endostar） in maintenance treatment of non-small cell lung adenocarcinoma （NSCLC）.Methods Totally 86 patients of advanced NSCLC confirmed by pathology from January 2011 to January 2013 were enrolled.After 4 cycles of maximum tolerated dose of CPA,the patients were randomly divided into observation group receiving CPA MET combined with Endostar and control group receiving CPA MET only.After six weeks of maintenance treatment,the peripheral blood T cell subsets,cytokine levels,short-term and long-term clinical efficacy and adverse reaction were compared between the two groups.Results The serum soluble Fas （sFas） was significantly reduced,the Interferon （IFN）-γ,tumor necrosis factor （TNF）-α and interleukin （IL）-2 were significantly increased after 6 weeks of maintenance treatment,compared with those before treatment in both observation group [（4 892 ± 195） ng/L vs （6 102 ±205） ng/L,（15.2 ±2.4）％ vs （7.8 ±2.8）％,（7.7 ±2.2）％ vs （6.6 ±2.1）％,（11.3±1.7）％ vs （9.2±1.1）％] and control group [（5 816±201） ng/L vs （6 096 ± 199） ng/L,（5.5 ±2.4）％ vs （7.8 ±3.1）％,（7.4 ± 0.5）％ vs （6.6±1.5）％,（10.6±1.8）％ vs （9.2±1.4）％] （P＜0.05）.After6 weeks of maintenance treatment,sFas was significantly lower,and IFN-γ,TNF-α,IL-2 levels were significantly higher in observation group compare with those in control group （all P ＜ 0.05）.After 6 weeks of treatment,the effective rate in observation group was significantly higher than that in control group [35.7％ （15/42） vs 13.6％ （6/44）,P ＜0.05].There were no significant differences regarding progression free survival and overall survival between the two groups （P ＞ 0.05）.The incidence of adverse reactions in the two groups showed no significant difference （P =0.465）.Conclusion CPA MET combined with endostar in maintenance treatment of NSCLC can significantly improve the immunity levels and the clinical efficacy.
出处
《中国医药》
2015年第5期629-633,共5页
China Medicine
关键词
环磷酰胺
节拍化疗
重组人血管内皮抑制素
非小细胞肺癌
Cyclophosphamide
Metronomic chemotherapy
Recombinant human endostatin
Non-small cell lung cancer
