螺旋断层放射治疗联合重组人血管内皮抑制素治疗不可切除且不能耐受同步放化疗的Ⅲ期非小细胞肺癌

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Abstract Objective To assess the efficacy and safety of recombinant human endostatin (Rh-endostatin) in combination with tomotherapy (TOMO) in the treatment of inoperable stage Ⅲ non-small cell lung cancer (NSCLC) patients who could not tolerate concurrent chemoradiotherapy.Methods Clinical data of 38 inoperable stage Ⅲ NSCLC patients were retrospectively reviewed, who could not tolerate concurrent chemoradiotherapy in the department of radiotherapy of Characteristics Medical Center of Chinese PLA Air Force from September 2014 to January 2020. All patients were treated with TOMO therapy combined with Rh-endostatin. The dosage of TOMO was 60-70 Gy in 15-25 fractions (5 fractions /week). Rh-endostatin was administered intravenously one week before TOMO at a dose of 7.5 mg/m² qd for 14 consecutive days, and repeated at an interval of one week for at least 4 cycles. Clinical efficacy, safety, and survival were assessed after the treatment.Results All patients were followed-up for a median duration of 42.6 (17.2-87.4) months. There were 25 (65.8%) patients with stage ⅢA NSCLC, and 13 (34.2%) patients with stage ⅢB NSCLC. In terms of pathological types, there were 18 (47.4%) cases of adenocarcinoma, 11 (29.0%) cases of squamous cell carcinoma, and 9 cases (23.7%) of others. All patients completed TOMO and at least 4 cycles of Rh-endostatin therapy, and 16 (42%) patients received more than 6 cycles of Rh-endostatin therapy among them. The median total survival time and progression-free survival time were 37.3 months 95%CI (11.3,85.2) and 23.1 months 95% CI(4.6,85.2) respectively, and the 3-year OS and PFS rate were 51.4% and 39.8% respectively.Multivariate analysis suggested that gender, age, smoking history and TNM stage were significantly associated with progression-free survival (PFS) and overall survival (OS), while weight loss was associated only with OS. TOMO dosage was only associated with local recurrence-free survival, but not with regional recurrence-free survival or distant metastases. The incidences of acute toxicities of grade 1/2 was 28.9% (n=11), and grade 3 was 5.3% (n=2). The incidence of late toxicities of grade 1/2 was 5.3% (n=2) and that of grade 3 was 2.6% (n=1); No grade 4/5 late toxicity occurred.Conclusions Rh-endostatin combined with TOMO is effective in the treatment of stage III non-small cell lung cancer patients who are inoperable and cannot tolerate concurrent chemoradiotherapy, and the adverse reactions are tolerable.

Key words： non-small cell lung cancer tomotherapy Rh-endostatin toxicity

Received: 14 February 2023

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	LIU Lihua
	YAN Maohui
	LI Hongqi
	FU Zhiguang

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LIU Lihua,YAN Maohui,LI Hongqi等. Efficacy and safety of recombinant human endostatin combined with tomotherapy in treatment of stage Ⅲ non-small cell lung cancer[J]. Med. J. Chin. Peop. Armed Poli. Forc., 2023, 34(9): 752-756.

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http://journal08.magtechjournal.com/Jwk_wjyx/EN/ OR http://journal08.magtechjournal.com/Jwk_wjyx/EN/Y2023/V34/I9/752

[1]	Rebecca L S, Kimberly D M,Ahmedin J.Cancer statistics, 2020[J]. Cancer J Clin, 2020, 70 (1): 7-30.
[2]	Xia C, Dong X, Li H, et al. Cancer statistics in China and United States, 2022: profiles, trends, and determinants[J]. Chin Med J (Engl),2022, 135(5):584-590.
[3]	Zhang Y, Naci H, Wagner A K, et al. Overall survival benefits of cancer drugs approved in China from 2005 to 2020[J].JAMA Netw Open, 2022, 5(8):e2225973.
[4]	Zare-Sakhvidi M J, Yang J, Mehrparvar A H, et al. Exposure to greenspace and cancer incidence, prevalence, and mortality: a systematic review and meta-analyses[J]. Sci Total Environ, 2022, 838(Pt 2):156180.
[5]	David S E, Dara L A, Douglas E W, et al. NCCN guidelines insights: non-small cell lung cancer, Version 5.2018[J]. Natl Compr Canc Netw, 2018, 16(7):807-821.
[6]	Fournel P. RTOG 94-10: keenly awaited results validating the best therapeutic strategy for locally advanced non-small cell lung cancer[J]. J Natl Cancer Inst, 2011, 103(19):1425-1427.
[7]	Mitchell M, Rebecca P, Jennifer M, et al. Defining local-regional control and its importance in locally advanced non-small cell lung carcinoma[J]. J Thorac Oncol, 2012, 7(4):716-722.
[8]	Higgins K A, Puri S, Gray J E. Systemic and radiation therapy approaches for locally advanced non-small-cell lung cancer[J]. J Clin Oncol, 2022, 40(6):576-585.
[9]	Bryan A C, Brett G M H. Targeted therapy for non-small cell lung cancer: current standards and the promise of the future[J]. Transl Lung Cancer Res, 2015, 4(1):36-54.
[10]	Mitchell M, Kyounghwa B, Benjamin M, et al. Higher biologically effective dose of radiotherapy is associated with improved outcomes for locally advanced non-small cell lung carcinoma treated with chemoradiation: an analysis of the radiation therapy oncology group[J]. Int J Radiat Oncol Biol Phys, 2012, 82(1):425-434.
[11]	Xia T Y, Li H Q, Sun Q X, et al. Promising clinical outcome of stereotactic body radiation therapy for patients with inoperable stage I/II non-small-cell lung cancer[J]. Int J Radiat Oncol Biol Phys, 2006, 66(1):117-125.
[12]	Chang J Y, Mehran R J, Feng L, et al. STARS Lung Cancer Trials Group. Stereotactic ablative radiotherapy for operable stage I non-small-cell lung cancer (revised STARS): long-term results of a single-arm, prospective trial with prespecified comparison to surgery[J]. Lancet Oncol, 2021, 22(10):1448-1457.
[13]	Li H Q,Li J, Wang X, et al. Promising clinical outcome with long term follow-up after body gamma knife stereotactic radiosurgery for patients with early stage non-small cell lung cancer[J]. Front Oncol, 2018, 21(8):618.
[14]	李宏奇, 夏廷毅. 体部 γ 刀治疗非小细胞肺癌的经验探讨[J]. 中华放射医学与防护杂志,2016, 36(10): 728-731.
[15]	许子宜, 李峻岭. 晚期非小细胞肺癌抗血管生成药物的联合治疗模式[J]. 中国肺癌杂志,2021,24(5): 357-364.
[16]	邢力刚,马晓林.2021版《中华医学会肿瘤学分会肺癌临床诊疗指南》非小细胞肺癌诊疗更新专家解读[J].疑难病杂志,2022,21(6):557-560.
[17]	Mistry H B. Simulating RTOG 0617 using genomic adjusted radiation dose: comparing apples with oranges[J]. J Thorac Oncol, 2021, 16(5):e27.
[18]	Yoshito K Michiko T, Yuji F, et al. A multicenter retrospective survey on a suicide trend using hydrogen sulfide in Japan[J]. Clin Toxicol (Phila), 2013, 51(5):425-428.
[19]	戈伟,明平坡,陈文卫, 等. 恩度联合放疗对肿瘤组织血流灌注和血管生成的影响[J]. 中华实验外科杂志,2014,31(5): 1051-1053.
[20]	郑伟,康静波,温居一, 等. 恩度联合放化疗对老年Ⅲ期非小细胞肺癌的疗效和毒副反应[J]. 中国医师杂志,2016,18(9): 3.
[21]	王毅,栾念旭,魏东. 恩度冲击量输注联合化疗对小细胞肺癌患者血清VEGF、循环内皮细胞、内皮抑素水平的影响[J]. 中国医师杂志,2018,20 (10): 1565-1567.
[22]	马红莲,彭芳,翟医蕊, 等. 不可手术局部晚期 NSCLC 隔周恩度联合同步放化疗多中心五年生存分析[J]. 中华放射肿瘤学杂志,2021,30(1): 23-28.