Effect observation of bevacizumab combined with DDP chemotherapy in treatment of patients with non-small cell lung cancer
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摘要: 目的 观察贝伐珠单抗联合DDP化疗方案(顺铂联合多西紫杉醇)对非小细胞肺癌(NSCLC)患者血管内皮生长因子(VEGF)、缺氧诱导因子-1α(HIF-1α)、基质细胞衍生因子-1α(SDF-1α)水平的影响。 方法 将64例NSCLC患者随机分为2组,每组32例。对照组予以DDP化疗方案治疗,观察组在对照组基础上予以贝伐珠单抗治疗。比较2组临床疗效、毒副反应发生率、治疗前后的血清VEGF-A、VEGF-B、VEGF-C、糖类抗原19-9(CA199)、癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)以及HIF-1α、SDF-1α的mRNA表达量。比较2组随访6、12、24个月的生存率。结果 观察组客观缓解率、疾病控制率高于对照组,差异有统计学意义(P<0.05)。治疗后,观察组血清VEGF-A、VEGF-B、VEGF-C、CA199、CEA、CYFRA21-1水平以及HIF-1α、SDF-1α的mRNA表达量低于对照组,差异有统计学意义(P<0.05)。2组毒副反应发生率相比,差异无统计学意义(P>0.05); 随访24个月,观察组生存率高于对照组,差异有统计学意义(P<0.05)。 结论 贝伐珠单抗联合DDP化疗方案可显著降低NSCLC患者血清VEGF、CA199、CEA、CYFRA21-1水平,抑制HIF-1α、SDF-1α表达,提高治疗效果及生存率,且安全性较好。Abstract: Objective To observe the effect of bevacizumab combined with DDP chemotherapy(cisplatin plus docetaxel)on the levels of serum vascular endothelial growth factor(VEGF), hypoxia-inducible factor-1α(HIF-1α)and stromal cell-derived factor-1α(SDF-1α)in patients with non-small cell lung cancer(NSCLC). Methods Totally 64 patients with NSCLC were randomly divided into two groups, with 32 cases in each group. Control group was treated with DDP chemotherapy, while observation group was treated with bevacizumab on the basis of the control group. Clinical efficacy, incidence of toxic and side effects, levels of serum VEGF-A, VEGF-B, VEGF-C, carbohydrate antigen 19-9(CA199), carcinoembryonic antigen(CEA), cytokeratin 19 fragment(CYFRA21-1)and expressions of mRNA of HIF-1α and SDF-1α before and after treatment were compared between two groups. The survival rates at 6, 12 and 24 months of follow-up were compared between the two groups. Results The objective response rate and disease control rate in the observation group were significantly higher than those in the control group(P<0.05). After treatment, the levels of serum VEGF-A, VEGF-B, VEGF-C, CA199, CEA, CYFRA21-1 and the expressions of mRNA of HIF-1α and SDF-1α in the observation group were significantly lower than those in the control group(P<0.05). There was no significant difference in incidence of toxic and side effects between two groups(P>0.05). At 24 months of follow-up, the survival rate of the observation group was significantly higher than that of the control group(P<0.05). Conclusion Bevacizumab combined with DDP chemotherapy can significantly reduce the serum levels of VEGF, CA199, CEA and CYFRA21-1, inhibit - the expressions of HIF-1α and SDF-1α, increase the therapeutic effect and survival rate, and has higher safety.
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