中国实用神经疾病杂志2024，Vol.27Issue(8)：990-997,8.DOI:10.12083/SYSJ.240015
重组人血管内皮抑制素联合脑部放疗与单纯脑部放疗治疗实体肿瘤脑转移的疗效及预后
Efficacy and prognosis of recombinant human endostatin combined with brain radiotherapy and brain radiotherapy alone for brain metastasis of solid tumors
摘要
Abstract
Objective To investigate the efficacy and prognosis of recombinant human endostatin(rh-Endostatin)combined with whole brain radiotherapy(WBRT)and WBRT alone in the treatment of brain metastasis of solid tumors.Methods The clinical case data of 94 patients who received treatment in the Department of Oncology,Ziyang People's Hospital from March 2020 to November 2022 were retrospectively analyzed.According to the treatment methods,they were divided into experimental group and control group,46 patients treated by WBRT were included in control group,and 48 patients treated by rh-Endostatin combined with WBRT were enrolled as experimental group.At 1 month after the end of treatment,the clinical efficacy and tumor markers(carcinoembryonic antigen(CEA),carbohydrate antigen(CA125),squamous cell carcinoma antigen(CA19-9),vascular endothelial growth factor(VEGFA,VEGFB,VEGFC)),immune function(CD3+,CD4+,CD8+,CD4+/CD8+),cerebral edema area and cerebral hemodynamic parameters(mean blood flow velocity and pulsatility index of anterior cerebral artery),quality of life(European Organization for Research and Treatment of Cancer quality of life questionnare(EORTCQLQ)),and neurocognitive level(mini-mental state examination(MMSE))were compared.The radiation injury during treatment was observed and compared between the two groups,and the survival curve was drawn for prognosis analysis.Results The total effective rate of clinical short-term efficacy in experimental group was higher than that in control group at 1 month after the end of treatment(47.92%vs 26.09%,P<0.05).The levels of tumor markers CEA,CA125,CA19-9,VEGFA,VEGFB,VEGFC,CD3+,CD4+,and CD4+/CD8+,cerebral edema area and pulsatility index in the two groups reduced significantly than those before treatment(P<0.05),and compared with control group,the levels of tumor markers and cerebral edema area in experimental group were significantly lower(18.76±2.54 vs 20.78±3.12,26.78±4.98 vs 33.12±5.19,31.34±3.12 vs 37.24±3.98,90.76±16.97 vs 121.78±18.12,83.78±11.02 vs 105.23±12.19,65.34±9.12 vs 83.23±10.98,144.58±71.55 vs 203.87±70.59),while the levels of CD3+,CD4+and CD4+/CD8+were significantly higher(59.67±4.33 vs 55.41±4.02,31.22±3.34 vs 27.74±3.79,1.17±0.22 vs 0.96±0.15)(P<0.05).The CD8+,mean blood flow velocity of anterior cerebral artery,scores of dimensions of EORTC and MMSE score in both groups were significantly enhanced compared with those before treatment(P<0.05),and the level of CD8+in experimental group was significantly lower(27.02±3.08 vs 28.92±3.31),while the mean blood flow velocity of anterior cerebral artery(56.67±3.33 vs 55.01±2.06),EORTC scores and MMSE score(26.58±1.11 vs 25.87±1.17)were significantly higher compared to control group(P<0.05).Mild radiation injury occurred in both groups during treatment,with no statistical difference(P>0.05).After treatment,the overall survival(OS)and progression-free survival(iPFS)were significantly longer in experimental group than those in control group(9.5 vs 7.5,8.0 vs 6.0)(P<0.05).Conclusion Rh-Endostatin combined with WBRT and WBRT alone can effectively improve the short-term efficacy in the treatment of patients with brain metastasis of solid tumors.It can safely and effectively inhibit tumor progression,improve cerebral blood flow,maintain cognitive function and quality of life,and protect immune function.The regimen has good safety and can prolong the OS and iPFS of patients to a certain extent.关键词
脑转移瘤/实体肿瘤/重组人血管内皮抑制素/脑部放疗/脑转移/预后Key words
Metastatic brain tumor/Solid tumors/Recombinant human endostatin/Brain radiotherapy/Brain metastasis/Prognosis分类
医药卫生引用本文复制引用
杨麒麟,魏敏,杨霞,丁莉,张凯,王国红,黄懿..重组人血管内皮抑制素联合脑部放疗与单纯脑部放疗治疗实体肿瘤脑转移的疗效及预后[J].中国实用神经疾病杂志,2024,27(8):990-997,8.基金项目
2020年四川省卫生健康委员会科研项目(编号:20PJ314) （编号:20PJ314）
