摘要目的 探讨重组人血管内皮抑制素联合TP方案(紫杉醇+顺铂)治疗晚期表皮生长因子受体(EGFR)野生型肺鳞状细胞癌的疗效.方法 选取2012年1月至2015年2月在重庆三峡中心医院就诊的肺鳞状细胞癌患者100例为研究对象,根据治疗方法分为单纯组(n=50)和联合组(n=50),单纯组使用TP方案,联合组在TP方案的基础上使用重组人血管内皮抑制素.依据实体瘤疗效评价标准1.1版(RECIST 1.1)进行治疗效果评价,并分析近期疗效、远期疗效、不良反应、住院时间及住院费用.结果 联合组患者的客观有效率为52.0％ (26/50),明显高于单纯组的16.0％ (8/50),差异有统计学意义(x2=14.429,P=0.007).联合组患者的疾病控制率明显高于单纯组(80.0％∶52.0％),差异有统计学意义(x2=8.734,P=0.009).与单纯组患者相比,联合组患者的中位无进展生存期(8.4个月:6.3个月)和总生存期(17.7个月∶11.5个月)明显延长,差异有统计学意义(x2=5.390,P=0.025;x2=3.993,P=0.035).单纯组患者的各种不良反应发生率与联合组基本一致,差异无统计学意义(均P＞0.05).与单纯组相比,联合组患者住院时间明显延长[(23.5±2.8)周∶(18.2±3.5)周],住院费用明显增加[(112 453.9 ±994.9)元∶(87 821.4 ±943.2)元],差异有统计学意义(t=8.361,P＜0.001;t=127.051,P＜0.001),但联合组患者满意度显著高于单纯组患者(88.0％∶64.0％,x2=4.210,P=0.017).结论 应用重组人血管内皮抑制素联合TP方案治疗晚期EGFR野生型肺鳞状细胞癌效果较好,不良反应发生率低,适于临床推广应用.

abstractsObjective To evaluate the efficacy of recombinant human endostatin combined with TP(paclitaxel + cisplatin) in the treatment of advanced epidermal growth factor receptor (EGFR) squamous cell lung carcinoma.Methods From January 2012 to February 2015,100 patients with squamous cell lung carcinoma in Chongqing Three Gorges Central Hospital for medical treatment were selected as the subjects.According to different treatment methods,they were divided into single group (n =50) and combined group (n =50).The single group used the TP protocol and the combined group was treated with recombinant human endostatin on the basis of the TP protocol.The therapeutic effect was evaluated according to the Response Evaluation Criteria In Solid Tumors 1.1 (RECIST 1.1).The short-term effects,long-term effects,adverse reactions,hospitalization time and expenses were also analyzed.Results The objective effective rate in the combined group [52.0％ (26/50)] was significantly higher than that in the single group [16.0％ (8/50)],with a significant difference (x2 =14.429,P =0.007).The disease control rate in the combined group was higher than that in the single group (80.0％ vs.52.0％),with a significant difference (x2 =8.734,P =0.009).Compared with the patients in the single group,the median progression free survival (8.4 months vs.6.3 months)and overall survival (17.7 months vs.11.5 months) in the combined group were prolonged obviously,with significant differences (x2 =5.390,P =0.025;x2 =3.993,P =0.035).The incidence rates of adverse reactions in single group were basically the same compared with the combined group,and the difference was not statistically significant (all P ＞0.05).Compared with the single group,the hospitalization time in combined group was longer [(23.5 ± 2.8) weeks vs.(18.2 ± 3.5) weeks],and the expenses in combined group was higher [(112 453.9 ± 994.9) yuan vs.(87 821.4 ± 943.2) yuan],with significant differences (t =8.361,P ＜0.001;t =127.051,P ＜0.001).But the satisfaction of patients in combined group was significantly higher than that in single group (88.0％ vs.64.0％,x2 =4.210,P =0.017).Conclusion Recombinant human endostatin combined with TP regimen is effective in the treatment of advanced EGFR wild-type squamous cell lung carcinoma,and has a low incidence of adverse reactions.It is suitable for clinical application.