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目的探讨沙利度胺在治疗局部晚期非小细胞肺癌中的抗血管生成作用。方法以该院2012年10月至2014年1月收治的40例局部晚期非小细胞肺癌患者作为研究对象,分为对照组(单纯同步放、化疗)和治疗组(在对照组基础上联合沙利度胺),每组各20例。同步放疗剂量60Gy,6周30次;化疗方案为PC(紫杉醇45~50mg/m~2,1次/周+卡铂AUC=2,1次/周)/EP(顺铂50mg/m~2第1、8、29、36天+VP16 50mg/m~2第1~5天、第29~33天);沙利度胺每日200mg口服,第1天起持续10周。采用酶联免疫吸附试验检测全部患者0、6、10周血清血管内皮细胞生长因子(VEGF)水平。结果治疗后第10周,治疗组VEGF水平[(220.35±82.61)pg/mL]明显低于对照组[(292.76±152.06)pg/mL],差异有统计学意义(P<0.05)。治疗组近期疗效有效率(55%)高于对照组(40%),但差异无统计学意义(P>0.05)。治疗组睡眠改善、体质量增加、食欲增加和疼痛缓解情况均优于对照组,差异均有统计学意义(P<0.05)。对照组受益4例,治疗组受益17例,差异有统计学意义(χ~2=16.942,P=0.000)。对照组和治疗组治疗后在非血液学毒性和血液学毒性方面差异均无统计学意义(P>0.05)。结论沙利度胺联合EP/PC方案同步放、化疗可显著降低血清VEGF水平,提高局部晚期非小细胞肺癌患者临床受益率,且未增加毒副作用。
Objective To investigate the anti-angiogenic effect of thalidomide in the treatment of locally advanced non-small cell lung cancer. Methods Forty patients with locally advanced non-small cell lung cancer admitted from October 2012 to January 2014 in our hospital were enrolled in this study. The patients were divided into control group (simple synchronous radiotherapy and chemotherapy) and treatment group Leid amine), each group of 20 cases. The dose of synchronous radiotherapy was 60 Gy, 30 times in 6 weeks; the chemotherapy regimen was PC (AUC of Paclitaxel 45 ~ 50mg / m ~ 2, once per week + carboplatin AUC = 2,1 times / Day 1,8,29,36 + VP16 50mg / m ~ 2 days 1 ~ 5, days 29 ~ 33); thalidomide 200mg orally daily for the first day of 10 weeks. Enzyme-linked immunosorbent assay was used to detect the levels of serum vascular endothelial growth factor (VEGF) in all patients at 0, 6 and 10 weeks. Results The level of VEGF in the treatment group [(220.35 ± 82.61) pg / mL] was significantly lower than that in the control group [(292.76 ± 152.06) pg / mL] at the 10th week after treatment. The difference was statistically significant (P <0.05). The effective rate (55%) in the treatment group was higher than that in the control group (40%), but the difference was not statistically significant (P> 0.05). The treatment group improved sleep, increased body weight, increased appetite and pain relief were better than the control group, the difference was statistically significant (P <0.05). The control group benefited 4 cases, the treatment group benefit 17 cases, the difference was statistically significant (χ ~ 2 = 16.942, P = 0.000). There was no significant difference in non-hematologic toxicity and hematological toxicity between the control group and the treatment group after treatment (P> 0.05). Conclusions Thalidomide combined with EP / PC regimen can significantly reduce the serum VEGF level and improve the clinical benefit rate of patients with locally advanced non-small cell lung cancer without increasing the toxic and side effects.