以白蛋白结合型紫杉醇为基础的方案治疗晚期肺癌的临床疗效及安全性观察

发布时间：2019-05-20 09:24

【摘要】：背景与目的白蛋白结合型紫杉醇是通过将人血白蛋白与紫杉醇相结合的无需助溶剂的新型紫杉醇制剂,本研究旨在观察白蛋白结合型紫杉醇治疗晚期肺癌的临床疗效及其安全性。方法选取2011年11月-2014年12月收治的进展期/不可手术的晚期肺癌患者共50例。给予白蛋白结合型紫杉醇130 mg/m2,第1天、第8天单药方案或者联合方案治疗,21 d为1个周期,观察每个周期不良反应,每2个周期按实体瘤疗效评价标准(Response Evaluation Criteria in Solid Tumors,RECIST)1.1进行影像学疗效评价。结果白蛋白结合型紫杉醇治疗总体客观有效率(overall response rate,ORR)为20%,疾病控制率(disease control rate,DCR)为68%。在亚组分析中,鳞癌ORR为26.7%,DCR为80%,明显优于其他病理类型,但是尚未达到统计学差异。以白蛋白结合型紫杉醇单药或者两药联合的基础上联合抗血管生成治疗可以提高ORR(36.4%vs 15.4%)。四线及以上治疗患者DCR仍可达到69.2%。主要不良反应为血液学毒性但是可控制,无超敏反应及4级不良反应发生。结论白蛋白结合型紫杉醇为基础的治疗方案治疗晚期肺癌无论其病理类型及治疗线数均有一定疗效,对于鳞癌及与抗血管靶向治疗联合时更有优势,即使对于老年及多线治疗后的患者耐受性较好。
[Abstract]:Background and objective Albumin binding paclitaxel is a new type of paclitaxel preparation which combines human blood albumin with paclitaxel without cosolvent. The purpose of this study was to observe the clinical efficacy and safety of albumin-combined paclitaxel in the treatment of advanced lung cancer. Methods from November 2011 to December 2014, 50 patients with advanced / non-operative advanced lung cancer were selected. Albumin-binding paclitaxel 130 mg/m2, was given on day 1, day 8, single or combined regimen, 21 days as a cycle, and the adverse reactions were observed in each cycle. The imaging efficacy was evaluated according to the solid tumor efficacy evaluation standard (Response Evaluation Criteria in Solid Tumors,RECIST) every 2 cycles. Results the overall objective effective rate of albumin-combined paclitaxel was 20% (overall response rate,ORR) and the disease control rate (disease control rate,DCR) was 68%. In subgroup analysis, ORR and ORR were 26.7% and 80%, respectively, which were significantly better than those of other pathological types, but there was no statistical difference. ORR (36.4%vs 15.4%) could be increased by antiangiogenic therapy on the basis of albumin-bound paclitaxel single drug or combination of two drugs. The DCR of patients treated with four lines or more could still reach 69.2%. The main adverse reactions were hematological toxicity but controllable, no hypersensory reaction and grade 4 adverse reaction. Conclusion Albumin-combined paclitaxel is effective in the treatment of advanced lung cancer regardless of its pathological type and the number of therapeutic lines, and has more advantages in combination with anti-vascular targeting therapy. Even for the elderly and patients after multiline treatment, tolerance is better.
【作者单位】：北京医院肿瘤内科国家老年医学中心;
【分类号】：R734.2

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