| Objective to observe and compare the efficacy ,safety and clicical benefit of endostar combined pemetrexed in patients with advanced retreatment non-small cell lung cancer(NSCLC).Method From Spetember 2008 to Spetember 2010, 60 advanced retreatment NSCLC(IIIB -IV ) patients who had confirmed by pathology and cytology and retreated with NP or TP or GP departmengt ,but not resuced by endostar and pemetrexed in the First Affiliated Hospital of Dalian Medical University were enrolled in this study. The age range was 43-71 and the median was 61.KPS score was between 70-90. 35 of these were male and 25 were female;28 were adenocarcinoma,19 were aquarmous cell carcinoma,and 13 were adenosquamous carcinoma; 22 were IIIB and 38 were IV ; 19 were retreated with TP department, 17 were TP and 24 were GP. 26 cases were given endostar and pemetrexed for 2-6 cycles and average cycle was 3.1(the experimental group; endostar 15ml/time/day add 100ml of normal saline and ivgtt for 14 days; pemetrexed mg/m2 add 100ml of normal saline and ivgtt in first day; repeated every 21 days); 34 cases were pemetrexed only for 2-6 cycles and average cycle was 3.4 (the control group; pemetrexed mg/m2 add 100ml of normal saline and ivgtt in first day). The efficacy was evaluated strictly according to RESIST criteria and PFS and OS were observed at the same time.The quality of life (QOL)was assessed by Karnofsky(KPS) scores after every 2 cycles of the treatment and the toxicity was evaluated accouding to WHO version criteria after every cycle of the treatment.Results In the experimental group, CR was 0%(0)and PR was 19.2%(5/26), SD 61.4% (16/26),PD19.2%(5/26) and the total effective rate RR(CR+PR) was19.2%(5/26); clinically benefical rate DCR(CR+PR+SD) was 80.7%(21/26); the median progression-free survival(mFPS) was 2.7months and the median survival time (MST) was 6.0 months. In the control group, CR was 0%(0)and PR was 14.7% (5/34), SD 41.2% (14/26),PD 44.1% (15/26) and the total effective rate RR(CR+PR) was14.7% (5/34); clinically benefical rate DCR(CR+PR+SD) was 55.9%(19/34);the median progression-free survival(mFPS) was 2.6months and MST was 5.8 month。There were no significant defference between the two groups in total effective rate, mPFS or mMST (P>0.05).But in the clicically benefitcal rate, there was significant defference (P<0.05).The main toxicities were myelosuppression and gastrointestinal reactions. In the experimental group, The incidence of neutropenia, thrombocytopenia and hematologic were30.7%,13.6%,13.6%.The rate of III-IV decrease were 3.8%,0,0. In the control group, the rate of neutropenia, thrombocytopenia and hematologic were32.4%,11.8%,11.8%.All of The III-IV decrease rate was 0.The rointestinal reactions were vomiting and liver function injury. The incidence of vomiting was30.8% in the experimental group and 32.4% in the control group.The rate of III-IV were 3.8% and 0 . The incidence of function injury 23.1% in the experimental group and 26.5% in the control group.The rate of III-IV were 0 and 2.9%.There was no case in arrhythmia. There was no significant difference between the two groups in untoward effects. The rate of improvement in quality of life were30.8%,26.5%and hae no significant difference.Conclusion 1.The department of endostar combined with pemetrexed is prior to pemetrexed only in clinically benefical rate of advanced retreatment non-small cell lung cancer(NSCLC) ,but there is no difference in progression-free surviva or survival time;2.The department of endostar combined with pemetrexed is safe and do not increase the rate of chemotheray adverse effect. |
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