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中国癌症防治杂志

中国癌症防治杂志

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沙利度胺对肺癌患者治疗前后血清VEGF水平的影响及临床意义

于起涛;宋向群;梁丹;王惠临;曾爱屏;周达;何剑波;周韶璋;   

  1. 广西医科大学肿瘤医院化疗二科;广西民族医院肿瘤科;
  • 收稿日期:2010-06-25 修回日期:2010-06-25 出版日期:2010-06-25 发布日期:2010-06-25

Effect of thalidomide on serum VEGF level of patients with advanced non-small cell lung cancer and its clinical significance

YU Qi-tao,SONG Xiang-qun,LIANG Dan,et al.   

  1. (Department of Chemotherapy,Affiliated Tumor Hospital of Guangxi Medical University,Nanning 530021;Department of Oncology,Guangxi Nationalities Hospital
  • Received:2010-06-25 Revised:2010-06-25 Online:2010-06-25 Published:2010-06-25

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被引次数

15

摘要： 目的观察沙利度胺联合第三代化疗药含铂方案治疗晚期非小细胞肺癌(NSCLC)的临床疗效及治疗前后血清中VEGF水平的变化。方法 66例经病理或细胞学证实的初治ⅢB～Ⅳ期NSCLC患者随机分为两组,其中联合组35例,接受沙利度胺联合第三代含铂方案治疗;单化组31例,接受第三代含铂方案化疗。并用ELISA方法检测患者治疗前后血清VEGF的浓度。结果联合组有效率(CR+PR)为45.7%,临床受益率(CR+PR+SD)为77.1%,中位疾病进展时间(TTP)为114d;单化组有效率38.7%,临床受益率58.1%,中位TTP为89d,两组有效率差异无统计学意义(P>0.05);两组临床受益率差异虽然无统计学意义(P=0.055),但联合组略高于单纯化疗组;两组治疗2周期后血清VEGF浓度均显著下降(P=0.000),两组PR、SD的病人治疗后VEGF浓度均下降明显,而PD的病人治疗前后VEGF浓度无明显变化。经沙利度胺干预后患者血清VEGF浓度的下降与单化组比较差异无统计学意义(P=0.513)。结论沙利度胺与第三代化疗药含铂方案联合应用,可提高非小细胞肺癌患者的临床受益率,但未观察到沙利度胺干预能使患者血清VEGF浓度明显下降。

关键词: 沙利度胺, 晚期NSCLC, VEGF

Abstract: Objective To investigate the efficacy of thalidomide combined with cisplatin-based chemotherapy,and the value of serum levels of vascular endothelial growth factor(VEGF)of the patients with advanced non-small cell lung cancer(NSCLC).Methods Sixty-six patients with histological or cytological confirmed diagnosis of stage ⅢB or Ⅳ NSCLC were enrolled in this study.All of the patients received no prior chemotherapy or radiotherapy or surgery.Thirty-five of the patients received thalidomide combined with platin-based chemotherapy(combined group),and the rest received platin only(control group).Serum VEGF levels were assessed by ELISA.ResultsThe response rates were 45.7% and 38.7% in combined group and control group respectively,the difference between the two groups was not statistically significant(P>0.05).Higher clinical benefit rate was found in combined group(77.1% vs 58.1%;P=0.048).The median time to progression(mTTP)in the combined group was significantly longer than that in the control group(114 days vs 89 days;P=0.033).The mean VEGF serum level in both groups decreased significantly after two courses of treatment(P=0.000).The mean VEGF serum level of the patients treated with thalidomide was not significantly lower than that without thalidomide(P=0.513).ConclusionThe treatment of thalidomide combined with platin-based chemotherapy can improve the clinical benefit and mTTP of NSCLC patient.However,the evidence that thalidomide can reduce the levels of serum VEGF is not obvious.

Key words: Thalidomide