重组人血管内皮抑素联合同步放化疗治疗老年晚期非小细胞肺癌的临床观察

目的 观察重组人血管内皮抑制素联合同步放化疗治疗老年晚期非小细胞肺癌（NSCLC）患者的近期临床疗效、不良反应及耐受性。方法将39例经病理组织学或细胞学检查确诊的ⅢB～Ⅳ期NSCLC老年患者随机分成两组，实验纽（19例）采用恩度联合同步放化疗治疗，对照组（20例）采用单纯同步放化疗治疗。采用调强放疗技术对肿瘤区域以及累及淋巴结区域进行放疗，总剂量DT60～76Gy／30～38次，共6～8周。化疗方案：多西他赛60mg／m^2第1天，顺铂30mg／m^2第1～3天，21d为1个周期，共3～4个周期。重组人血管内皮抑素15mg／d，第1～14天连续给药，与化疗同步进行。按照WHO标准评价近期疗效，参考KPS评分以及患者临床症状缓解情况评价患者的生活质量（QoL）；按照WHO抗癌药物不良反应分度标准评价不良反应。结果试验组和对照组的客观有效率（RR）分别为84．2％和50．0％（P〈0．05），临床受益率（CBR）分别为94．7％和70．0％（P〈0．05）；QoL改善稳定率为94．7％（18／19）和90．0％（18／20）（P〉0．05）；在血液学及非血液学不良反应主要有中性粒细胞减少、血小板减少、恶心、呕吐、乏力、心律失常、过敏，Ⅲ级以上不良反应发生率试验组和对照组差异无统计学意义；两组放射性食管炎和放射性肺炎的发生率分别为15．8％和10．0％（P〉0．05）。结论重组人血管内皮抑素联合同步放化疗治疗老年晚期非小细胞肺癌，近期疗效有所提高，不良反应轻，易于接受。

Endostar combined with concurrent chemoradiotherapy in treatment of local advanced non - small cell lung cancer in elderly patients

Objective To investigate the short -term efficacy, safety and toxicities and tolerance of concurrent chemoradiotherapy combined with endostar for advanced non - small cell lung cancer （NSCLC） in elderly patients. Methods A total of 39 patients were randomly divided into trial group （19 cases） and control group（20 cases）. In the trial group, the patients received endostar combined with chemoradiotherapy concurrently. In the control group, the patients received only chemoradiotherapy concurrently. The patients were given intensity - modulated radiotherapy （IMRT） , the dose of primary tumors and involved lymph nodes was 60 - 76 Gy/30 - 38 times for 6 - 8 weeks. Concurrently they were administrated chemotherapy with or without endostar. Docetaxel 60 mg/m2 on day 1, DDP 30 mg/m2 on day 1 -3,the chemotherapy was repeated every 21 days as a cycle. The endostar was given 15 mg/d from day 1 - 14 simultaneously. The efficacy was evaluated according to RECIST criteria, quality of life （QOL） was evaluated by karnofsky, safety was evaluated according to NCICTC 3.0 version criteria. Resuits The overall response rate was 84. 2% in the trial group and 50.0% in the control group respectively （ P 〈 0.05）. The clinical benefit rate was 94. 7% in the trial group and 70.0% in control group （ P 〈 0.05）. The rates of improved and stabled QoL were 94.7% and 90. 0% （ P 〉 0. 05）, respectively. The main side effects were marrow suppression and gastrointestinal symptoms. The total incidence of side effects in treatment group was higher than that in control group, but there was no significanct difference existed （ P 〉 0.05 ）. Conclusions Endostar combined with concurrent chemoradiotherapy iseffective, safe and well- tolerable in the treatment of advanced NSCLC in elderly patients.