恩度联合化疗对恶性浆膜腔积液治疗作用的临床观察.docVIP

恩度联合化疗对恶性浆膜腔积液治疗作用的临床观察 福建医科大学教学医院福州肺科医院肿瘤内科 陈 群 石 琴 谢 强 肖 松* 李育宏 林江平 王成辉 王 琳 　　【摘　要】　目的：观察抗肿瘤新药重组人血管内皮抑素注射液(YH-16, 恩度)联合化疗治疗多种晚期恶性肿瘤时，对合并有恶性浆膜腔积液作用的有效性和安全性。方法：经病理组织学或细胞学检查确诊的恶性肿瘤患者9 例, 其中非小细胞肺癌(NSCLC)7 例,其他肿瘤2 例(食管癌、乳腺癌各1例)，接受恩度联合化疗的方案治疗。其中恩度15 mg,加入生理盐水500 ml中匀速缓慢静脉滴注,第1～14 天连续给药,间歇7 天重复；同时联合既往未使用的或与既往治疗无交叉耐药的化疗药物。每21 天为1 个周期。按照WHO标准评价近期疗效，参照Karnofsky评分(KPS )变化评价生活质量(QOL ),按照NCI CTC 3.0 版标准评价毒性反应。用药1 周期即可评价毒性，2 周期后方可评价疗效。结果：全组9 例患者均可安全性评价，共完成的周期数为23 个周期，平均2.56 个周期。9 例完全控制；而生活质量改善者有7 例(77.8% ),稳定者1 例(11.1% ),仅1 例(11.1% )下降。G3 /4 级毒性主要与化疗药物有关,仅有6 例次，包括白细胞下降、血小板下降、皮疹、腹泻以及疲惫各有1 例。结论：恩度与化疗药物联合使用可以改善和稳定多种晚期恶性肿瘤合并浆膜腔积液患者的生活质量，与部分化疗药物具有协同作用,其毒性低，安全性好,值得临床上推广应用和进一步深入观察。 　　【关键词】　重组人血管内皮抑素/恩度； 　恶性浆膜腔积液； 　化疗； 　抗肿瘤血管形成　 Endostar combined with chemotherapy on the malignant serous cavity effusion　　CHEN qun , SI qing , XIE qiang , LI yu hong ,XIAO song , LIN jiang ping , WANG chen hui , WANG lin . Department of Tumour , Fuzhou Pulmonary Hospital of Fujian medical college teaching hospital , Fuzhou 350008 , China . 　　【Abstract】　Objective: To observe the efficacy and safety of rhendostatin injection (YH-16,Endostar) , a new molecular targeted antitumor agent, combined with the chemotherapy on the malignant serous cavity effusion . Methods: Endostar combined with chemotherapy were administrated to 9 advanced malignant cases ( including 7 cases with non-small cell lung cancer , 2 cases with other cancers) confirmed by histopathology or cytopathology. 15mg endostar solved in 500ml of normal saline was slow intravenously dropped from day 1 to day 14, repeated after 7 days later. The chemotherapy agents which was not used before or not cross-resistant to pre-chemotherapeutic agents were selected to be given simultaneously. The regimen was repeated every 21days. The efficacy was evaluated strictly after 2 cycles according to WHO criteria, and quality of life (QOL) was evaluated according to Karnofsky scores. Otherwise safety was evaluated after 1 cycle according to NCI CTC 3.0 v