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目的探讨贝伐珠单抗联合标准化疗一线治疗晚期肺腺癌的疗效及安全性。方法19例经病理学或细胞学确诊的晚期肺腺癌患者,均为初治,给予贝伐珠单抗7.5mg/kg联合紫杉醇和卡铂方案或联合培美曲塞和顺铂或卡铂方案治疗,每21天为1个周期,每2个周期进行疗效评价,达CR、PR和SD的患者4～6个周期后继续贝伐珠单抗单药维持治疗,21天为1个周期,直至病情进展或不能耐受。按照实体瘤疗效评价标准(RECIST)进行疗效评定,采用NCI CTC-AE第3版进行毒性反应评价。结果 19例患者中无完全缓解(CR),部分缓解(PR)11例(57.9%),稳定(SD)6例(31.6%),进展(PD)2例(10.5%),总有效率(RR)为57.9%,疾病控制率(DCR)为89.5%。采用Log-rank单因素分析对可评价的11例晚期肺腺癌患者无进展生存时间(PFS)进行统计分析,结果显示PFS为6.9个月。全组患者毒性反应较轻,主要为乏力、骨髓抑制、消化道反应、高血压及蛋白尿,多为Ⅰ～Ⅱ级。结论贝伐珠单抗联合标准化疗一线治疗晚期肺腺癌疗效较好、安全性较高,值得临床进一步观察。
Objective To investigate the efficacy and safety of bevacizumab combined with standard chemotherapy in the treatment of advanced lung adenocarcinoma. Methods Nineteen patients with advanced lung adenocarcinoma diagnosed by pathology or cytology were initially treated with bevacizumab 7.5 mg / kg combined with paclitaxel and carboplatin or with pemetrexed and cisplatin or carboplatin Program treatment, every 21 days for a cycle, every 2 cycles of efficacy evaluation, up to CR, PR and SD patients 4 to 6 cycles to continue bevacizumab monotherapy maintain treatment, 21 days for a cycle Until the disease progresses or can not tolerate. The curative effect was evaluated according to RECIST, and NCI CTC-AE version 3 was used to evaluate the toxicity. Results There was no complete response (CR), partial response (PR) in 11 cases (57.9%), stable (SD) in 6 cases (31.6%) and progression (PD) in 2 cases RR) was 57.9% and the disease control rate (DCR) was 89.5%. Statistical analysis of progression-free survival time (PFS) in 11 evaluable patients with advanced lung adenocarcinoma using Log-rank univariate analysis showed that the PFS was 6.9 months. Toxicity in all patients was mild, mainly as fatigue, myelosuppression, gastrointestinal reactions, hypertension and proteinuria, mostly grade Ⅰ ~ Ⅱ. Conclusion Bevacizumab combined with standard chemotherapy first-line treatment of advanced lung adenocarcinoma better efficacy, higher safety, it is worth further clinical observation.