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Cervical cancer is one of the most common malignant tumors in women worldwide. Locally advanced cervical cancer is mainly treated with radiotherapy and chemotherapy, but there are problems such as high recurrence rate and low survival rate. Bevacizumab, an angiogenic inhibitor that acts on vascular endothelial growth factor (VEGF), has been recommended by the National Comprehensive Cancer Network (NCCN) guidelines for the first-line treatment of recurrent / metastatic advanced cervical cancer in 2013. In recent years, the development of new targeted drugs for angiogenesis inhibitors, such as endostatin, has further optimized the new targeted therapy strategy for patients with locally advanced and advanced cervical cancer. Recombinant human endostatin (endostar) is a novel anti-angiogenesis drug independently developed by Chinese scientists. Although it has been applied in the treatment of cervical cancer, it needs to be further confirmed by high level evidence based medical evidence whether it can become a new option for targeted treatment of cervical cancer. In this article, clinical research progress on the treatment of cervical cancer by endostar combined with radiotherapy and / or chemotherapy was reviewed, aiming to provide reference for the optimization of cervical cancer treatment strategy.
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AIM: To compare the clinical efficacy of conbercept and aflibercept in the treatment of wet age-related macular degeneration(wARMD)based on 4 consecutive intravitreal injections.METHODS: The clinical data of 108 patients(108 eyes)who were diagnosed as wARMD and treated with intravitreal injection at our hospital from January 2019 to January 2021 were retrospectively analyzed. They were divided into conbercept group(54 cases, 54 eyes)and aflibercept group(54 cases, 54 eyes)according to the different injectable drugs. All patients received intravitreal injection once a month, with four consecutive injections. Follow up for 12mo to observe best corrected visual acuity(BCVA), central macular thickness(CMT), complications and recurrence before and after injection.RESULTS: BCVA and CMT of patients in the two groups at 1, 2, 5 and 8mo after injection had no between-group differences(P>0.05), but both were significantly improved compared with those before injection(P<0.05). By the end of follow-up, conjunctival hemorrhage occurred in 2 eyes of the conbercept group at the early stage, and increased intraocular pressure and conjunctival hemorrhage occurred respectively in 2 eyes of the aflibercept group. There were no serious complications related to drug injection such as retinal detachment, complicated cataract, endophthalmitis and retinal pigment epithelial tear in the two groups, and there was no difference in the recurrence rate between the two groups(7% vs. 6%, P=1.000).CONCLUSION: On the basis of continuous 4 times of intravitreal injection, both conbercept and aflibercept are safe and effective in the treatment of wARMD, and the efficacy is even.
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Objective:To explore the establishment of radiation-induced heart damage (RIDH) SD rat models caused by irradiation of 15Gy/3f and the changes in early detection indicators, and evaluate the effect of irradiation combined with recombinant human endostatin (Endostar).Methods:75 adult male SD rats were randomly divided into the blank control group (C group), Endostar group (E group), 25Gy irradiation group (MHD 25 group), 15Gy irradiation group (MHD 15 group) and 15Gy irradiation combined with Endostar group (MHD 15+ E group), respectively. Blood sample was taken to measure the CK, CK-MB, LDH and CRP at 24h, 48h and 15d after corresponding interventions. After cardiac echocardiography at 1, 3 and 6 months, 5 rats in each group were randomly sacrificed and myocardial tissues were collected for HE and Masson staining. Two-way ANOVA was employed for statistical analysis. Results:Compared with group C, myocardial fibrosis were observed in the MHD 15 group at 6 months ( P<0.05), which occurred later than that in the MHD 25 group. Ejection fraction (EF) and fractional shortening (FS) were significantly decreased after 3 months in each irradiation group (all P<0.05), whereas the degree of decrease was similar among all groups (all P>0.05). The expression levels of myocardial enzymes and inflammatory cytokines did not significantly differ among different groups (all P>0.05). Conclusions:In the early stage, exposure to 15Gy/3f irradiation can cause cardiac function damage in SD rat hearts, such as the reduction of EF and FS, and even lead to myocardial fibrosis in the late stage, which is delayed and less severe than high-dose irradiation. Irradiation combined with Endostar has no significant effect on radiation myocardial injury in rats.
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@#The main treatment of head and neck cancer is comprehensive sequential treatment, but the 5-year overall survival rate is less than 50%. Strategies to further improve the curative effect of head and neck cancer are urgently needed in the clinic. Recombinant human vascular endostatin is an antiangiogenesis drug targeting vascular endothelial cells, which has a certain inhibitory effect on tumors. The treatment of malignant tumors by drugs alone is not significantly better than chemoradiation, but combined with radiotherapy and chemotherapy, it can increase the effect of radiotherapy and chemotherapy without drug resistance by changing the distribution of blood vessels, reducing oxygen and normalizing blood vessels. Head and neck tumor treatment has certain advantages. New tumor treatments are expected. The results of a literature review showed that the mechanism of action of recombinant human endostatin mainly includes regulating the matrix protein inside and outside the endothelial cells to influence neovascularization, acting on receptors related to the surface of endothelial cells, reversing abnormal neovascularization to achieve vascular normalization, inhibiting hypoxia inducible factor to improve the hypoxic status of the tumor area, and regulating the cell cycle to ensure the tumor cells are sensitive to radiation in the sensitive period, and vascular normalization can increase the effect of radiotherapy. This treatment has a good synergistic effect with radiotherapy and chemotherapy of head and neck tumors and has a good effect on advanced head and neck tumors.
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Objective: To observe the effect of recombinant human endostatin (endostar) combined with chemotherapy on advanced colorectal cancer. Methods: A total of 120 inoperable patients with advanced colorectal cancer who were admitted to the Guizhou Cancer Hospital from June 2014 to June 2018 were selected. The patients were divided into two groups. Sixty cases were allocated to the test group and received endostar of 15 mg/d, d1-d7, which was repeated after 7 and 14 days. Chemotherapy was initiated on the 5th day of endostar (endostar window period). Sixty patients were allocated to the control group and received endostar of 15 mg/d, d1-d14, which was repeated after 7 and 21 days. Chemotherapy was initiated on the 1st day of endostar. The chemotherapy regimen used was mFOLFOX6 or FOLFIRI. Results: The objective response rate (ORR) of the test and control groups was 25.0%, and 18.3%, respectively, and the disease control rate (DCR) was 80.0% and 73.3%, respectively. The difference was not significant (P=0.375, P= 0.388). The 1-year survival rate of the test group and the control group was 69.6% and 62.5%, respectively, while the 2-year survival rate was 39.7% and 21.3%, respectively. Moreover, the 3-year survival rate was 26.8% and 13.3%, respectively, and the median survival time was 22 months (95% CI 16.817-27.183) and 16 months (95% CI 11.890-20.110), respectively. In contrast to the control group, the survival rate increased and the survival time was prolonged in the test group (P=0.033). The progression time (TTP) of median disease in the test and control groups was 9 months and 8 months, respectively. This was not statistically significant (P>0.05). Conclusions: This study found that chemotherapy with recombinant human endostatin in the window stage can enhance the 1, 2, and 3-year survival rate of patients with advanced colorectal cancer, as well as prolong the median survival time.
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OBJECTIVES@#To observe the efficacy and adverse reactions of the combination of endostar with chemotherapy in the treatment of advanced (IVb) and recurrent metastatic cervical cancer.@*METHODS@#Forty-four patients with recurrent and metastatic cervical cancer, who were admitted to the Second Xiangya Hospital, Central South University from December 2016 to December 2018 were randomly divided into an experimental group and a control group (22 cases in each group). The control group was given gemcitabine plus cisplatin (GP) or docetaxel plus cisplatin (DP) treatment, the experimental group was treated with endostar on the basis of the control group.@*RESULTS@#The objective response rate (ORR) was 42.9% in the experimental group and 22.7% in the control group. There was no significant difference between the 2 groups (@*CONCLUSIONS@#Compared with chemotherapy alone, endostar combined with chemotherapy can prolong the median progression-free survival, with higher ORR and similar adverse reactions.
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Female , Humans , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Cisplatin/therapeutic use , Endostatins , Lung Neoplasms/pathology , Neoplasm Recurrence, Local/pathology , Neoplasm Staging , Recombinant Proteins , Uterine Cervical NeoplasmsABSTRACT
Objective@#To evaluate the feasibility of intravoxel incoherent motion diffusion-weighted magnetic resonance imaging (IVIM-DWI MRI) in the evaluation of tumor vascular normalization in a mouse model of colorectal cancer induced by recombinant human endostatin (rhES).@*Methods@#The CT26 colorectal cancer xenograft model of BALB/c mice were established and divided into rhES group and control group, with 20 mice in each group. The mice of rhES group were intravenously injected with rhES 5 mg·kg-1·d-1 once daily for 12 days, while the mice of the control group were intravenously injected with the same volume of 0.9% saline. 5 mice of rhES group and control group were randomly selected to perform IVIM-DWI MRI as following times: before treatment and four, eight, twelve days after treatment. The parameters of IVIM-DWI were recorded, including true diffusion coefficient(D), pseudo-diffusion coefficient (D*) and perfusion fraction (f). Meanwhile, microvessel density (MVD), pericyte coverage and tumor perfusion in tumor tissues were detected by immunofluorescence, respectively.@*Results@#The tumor volumes of control group and rhES group before treatment were (154.42±24.65) mm3 and (174.24±28.27)mm3, respectively, without statistically significant difference (P=0.440). From day 2 to day 12 after treatment, the tumor volume of rhES group was significantly smaller than that of control group (all P<0.05). There were no statistical significances of D value between the rhES group and control group before and after treatment (all P>0.05). The D* values of the rhES group were (10.940±2.834)×10-3mm2/s and (12.940±2.801)×10-3mm2/s in day 4 and 8 after treatment respectively, significantly higher than (6.980±1.554)×10-3mm2/s and (7.898±1.603)×10-3mm2/s of control group (P<0.05). Moreover, compared with control group, the D* value of rhES group was significantly lower in day 12 (6.848±1.460)×10-3mm2/s vs (9.950±2.596)×10-3mm2/s, (P<0.05). The f value of rhES group in day 8 was (0.226±0.021)%, significantly higher than (0.178±0.016)% of control group (P<0.01). The MVD of rhES group was significantly lower than that of control group (P<0.05), while the pericyte coverage and tumor perfusion of rhES group were significantly higher than those of control group in day 4 and 8 after treatment (all P<0.05). In addition, we found D* value of IVIM-DWI in rhES group was significantly related with MVD, pericyte coverage and tumor perfusion (r=-0.354, r=0.555, r=0.559, all P<0.05). Meanwhile, the f value in rhES group was also significantly related with MVD, pericyte coverage and tumor perfusion (r=-0.391, r=0.538, r=0.315, all P<0.05).@*Conclusions@#IVIM-DWI MRI can effectively evaluate the vascular normalization in rhES-induced CT26 colorectal tumor.The parameters D* and f are closely related to intratumorally microvessel density, pericyte coverage and perfusion, which can effectively monitor the occurrence of tumor vascular normalization time.
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Objective: To investigate the clinicopathological characteristics, diagnosis, and treatment of malignant perivascular epithelioid cell tumor (PEComa) in kidney. Methods: The cinical diagnosis and treatment outcome of a case of PEComa were reported. The morphological characteristics of renal PEComa were analyzed. The PEComa-related literatures were reviewed, and the diagnosis and treatment strategies of PEComa were summarized. Results: A 21-year-old female patient with a solid mass in the left kidney underwent nephrectomy. The pathological examination revealed PEComa. After 2 years, the computed tomography (CT) scan showed several masses in the lung and bone, which were speculated to be metastases from the kidney lesion. The patient received chemotherapy with recombinant human endostatin and Apatinib. Despite active treatment, the tumor was still progressing, and the patient died of respiratory failure 45 months after the original diagnosis. Literature reviews showed that PEComa patients had not typical clinical symptoms, and the positive immunohistochemical results of human melanoma black-45 (HMB45), melanoma antigen (Melan-A), and smooth muscle actin (SMA) were the key features in the diagnosis of PEComa. Conclusion: PEComa is a kind of rare tumor. The diagnosis and treatment of this disease should be intensified, and the long-term close follow-up is necessary.
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Objective To evaluate the short-term efficacy of recombinant human endostatin (rhES) combined with transcatheter arterial chemoembolization (TACE) versus TACE alone for intermediate and advanced primary hepatic carcinoma.Methods The relevant controlled trials about rhES plus TACE versus TACE alone in the treatment of intermediate and advanced primary hepatic carcinoma were retrieved from the databases of PubMed,Elsevier,Cochrane Library,China National Knowledge Infrastructure (CNKI),Chinese Biomedical Literature Database (CBM),Wan Fang Database.The retrieval time limited was from the database construction to January 2018,and the Meta-analysis was performed by using RevMan5.3 software.Results 18 controlled trials were included in this Meta-analysis.There were 948 cases,of which 522 cases in rhES plus TACE group and 426 cases in TACE alone group.According to the usage of rhES,the trials were further divided into intrahepatic arterial embolization group,intrahepatic arterial pump group,and intravenous infusion group.rhES plus TACE had an overall advantage over TACE alone in terms of objective response rate (ORR),and the difference was statistically significant (RR =1.59,95％CI:1.41～1.79,P＜0.05).And the ORR of rhES plus TACE in intrahepatic arterial embolization group,intrahepatic arterial pump group,intravenous infusion group was better than that of TACE alone (Intrahepatic arterial embolization group RR=1.63,95％CI:1.36～ 1.95;Intrahepatic arterial pump group RR=1.49,95％CI:1.24～1.79;Intravenous infusion group RR=1.69,95％CI:1.22～2.34),and the difference was statistically significant (P＜0.05).The subgroups analysis of anthracycline and platinum also showed that ORR in rhES plus TACE patients was better than that in TACE patients alone.Conclusion The short-term efficacy of rhES plus TACE in the treatment of intermediate and advanced primary hepatic carcinoma was better than that of TACE alone,and the same results were obtained by subgroup analysis.
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Objective To investigate the efficacy and safety of two antiangiogenic drugs (recombinant human endostatin endostar and thalidomide ) combined with capecitabine and oxaliplatin (XELOX) regimens in the treatment of advanced colorectal cancer.Methods From January 2015 to May 2018,40 patients of advanced metastatic colorectal cancer with organ metastasis and non?resectable were selected from the first people′s hospital of Hefei and Anhui Provincial Hospital, and they were randomly divided into treatment and control group, with 20 cases in each group.The treatment group received intravenous infusion (IV) of endostar for continuous 7 days (day 1～7) combined with oral administration of thalidomide for continuous 14 days (day 1～14) plus XELOX regimens after the fifth dose of endostar (day 6～19),and the control group was treated with XELOX regimen (day6～19).Results The objective response rate (ORR) was 50%(10／20) and 20%(4／20) respectively (χ2＝3.956,P＜0.05),the disease control rate (DCR) was 85%( 17／20) and 70%(14／20) respectively ( χ2＝1.290,P＞0.05),and the median progression free survival (mPFS) was 6.8 in both groups.There was no significant difference in Karnofsky performance score ( KPS) and incidence of adverse reactions between the two groups before and after treatment (P＞0.05).Conclusion Combination of endostar and thalidamide plus XELOX regimen as first?line treatment have better antitumor activity and are well?tolerated in patients with advanced colorectal cancer.
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@#Objective To study the short-term outcome and safety of radiofrequency ablation (RFA) combined with recombinant human endostatin (endostar) for non-small cell lung cancer (NSCLC) patients. Methods Between December 2013 and December 2014, 80 consecutive patients (50 males, 30 females) with biopsy-proved NSCLC were divided into two groups: a RFA combined treatment group (RFA combined with endostar, 60 patients, 38 males, 22 females, mean age at 67.77±10.43 years) and a RFA alone group (20 patients, 12 males, 8 females, mean age at 67.35±9.82 years). The RFA combined treatment group was divided into three groups according to vascular normalization window of endostar and 20 patients in each group: a combined treatment group 1 (transfusion of endostar after RFA), a combined treatment group 2 (transfusion of endostar for 1 to 3 d before RFA) and a combined treatment group 3 (transfusion of endostar for 4 to 7 d before RFA). The CT scan of the chest was followed up after the treatment, local recurrence and safety was observed. Results There was a statistical difference in local recurrence time among groups (χ2 = 11.05, P =0.011). The effect of the combined treatment group is better than that of the radiofrequency ablation therapy alone group. And in the recombinant human endostatin of tumor vascular normalization time best combination therapy was observed in the near future effect compared with the radiofrequency ablation therapy alone. In this study common complications were associated with radiofrequency ablation. No recombinant human endostatin related complication was found. There was no satistical difference in safety between the combined treatment group and the radiofrequency ablation therapy group (χ2= 0.889, P > 0.05). Conclusion RFA combined with endostar is safe and effective for non-small cell lung cancer.
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OBJECTIVE:To observe the clinical efficacy and safety of recombinant human endostatin (rh-endostatin) combined with Lobaplatin for injection and irinotecan injection in the treatment of advanced recurrent small cell lung cancer (SCLC). METHODS:A total of 88 patients with advanced recurrent SCLC in our hospital were divided into control group (41 cases) and observation group (47 cases) according to random number table. Control group was given Irinotecan injection+Lobaplatin for injection. Observation group was additionally given Recombinart human endostatin injection 15 mg added into 0.9%Sodium chloride injection 250 mL,ivgtt,qd,for consecutive 14 d,every 14 d. A treatment course lasted for 28 d,and both groups were treated for 2 courses. The clinical efficacy,the levels of serum carcinoembryonic antigen(CEA),the scores physical state (ECOG) and quality of life (QOL) before,after treatment were observed in the two groups,and the survival and adverse reactions of the two groups were compared. RESULTS:The total response rate of observation group was 59.6%,which was higher than 43.9% of control group,but there was no statistical significance (P>0.05). Before treatment, there was no significant difference in serum CEA levels,ECOG scores or QOL scores,between 2 groups(P>0.05);after treatment,the serum CEA levels of the two groups were significantly decreased,and the observation group was significantly lower than the control group,with statistically significant (P<0.05). In observation group,ECOG scores decreased while QOL scores increased significantly,and significantly better than the control group,with statistical significance(P<0.05). The overall survival(OS)of observation group was 16.8 months,which was significantly higher than 11.5 months of control group,with statistical significance (P<0.05). The incidence of leucopenia in observation group was significantly higher than control group;the incidence of leucopenia and abnormal liver function were significantly lower than control group,with statistical significance(P<0.05). CONCLUSIONS:Rh-endostatin injection combined with lobaplatin and irinotecan can improve serum CEA levels and the quality of living aswell as prolong the survival time.
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Objective To investigate the effect of recombinant human endostatin combined with chemotherapy on the expression of vascular endothelial growth factor (VEGF) in patients with advanced cancer.Methods250 patients with advanced malignant tumors were randomly selected from February 2012 to February 2016 the Third Hospital of Jiaxing, with unit control method experiment principle divided into two groups: experimental group (125 cases) and control group (125 cases).The experimental group treated by recombinant human endostatin combined chemotherapy, control group received routine chemotherapy for a week during the period of 21 days, after two cycles of treatment, clinical efficacy and adverse reactions of the two groups of patients were compared, and the expression of VEGF in tumor blood vessels weredetected.ResultsAfter two cycles of treatment, objective response rate, disease control rate in the experimental group patients was significantly higher than that in control group (P<0.05);after treatment, the expression level of VEGF in serum of the experimental group and the control groupwere decreased significantly, but the experimental group was lower than that of control group was more obvious (P<0.05).ConclusionRecombinant human endostatin combined with chemotherapy in the treatment of advanced malignant tumors can enhance the effect of chemotherapy, regulate the level of VEGF.
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Objective To observe the effect of endostatin(Endostar) combined with radiotheraphy on the growth,microvessel density (MVD),the expressions of regulators of G-protein signaling 5 (RGSS),vascular endothelial growth factor (VEGF) and hypoxia-induced factor-1 α (HIF-1 α) ingastric transplantation tumor,and to explore underlying mechanism.Methods Thirty-two tumor-bearing mice were randomly divided into four groups including control group,ES group,RT group and ES + RT group.Then the tumor-bearing mice survival and tumor volume alterations were observed.After treatments of drug and RT,the inhibition rate of tumor growth and tumor MVD were measured.Immunohistochemical staining method was used to detect the expressions of RGS5,VEGF and HIF-1α.Results Compared with the ES group and control group,the ES + RT and RT treatment had effective anti-tumor effect(t=7.4,5.6,P ＜ 0.05),where as the ES + RT was more obvious in anti-tumor with the lowest value of MVD in tumor.Compared with the control group,the expression of HIF-1α in ES group,RT group,and especially ES + RT group was significantly reduced (t =6.5,8.2,13.1,P ＜ 0.05).The expression levels of VEGF and RGS5 wereincreased in RT group but was reduced in ES group and ES + RT group,and the expressions of VEGF and RGS5 in ES group and ES + RT group had no significant difference (P ＞ 0.05).Rank correlation analysis showed the expression of HIF-1α and the expressions of VEGF and RGS5 were positively correlated (r =0.57,0.71,P ＜ 0.05).Conclusions A possible mechanism of Endostar combined with radiotherapy on tumor growth inhibition may due to the inhibition of HIF-1α and its downstream VEGF and RGS5,and then inhibit tumor angiogenesis that results in the recovery of tumor blood vessels and tumor oxygen supplement.
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OBJECTIVE:To observe therapeutic efficacy and safety of S-1 capsules combined with recombinant human end-ostatin in the treatment of middle and advanced primary liver carcinoma. METHODS:Totally 94 patients with middle and advanced primary liver carcinoma in the First College of Clinical Medical Science of China Three Gorges university during Feb. 2012-Dec. 2014 were divided into combination group(48 cases)and control group(46 cases)according to random number table. Both groups were given S-1 capsules 40-60 mg orally within 30 min after breakfast and supper. Combination group additionally received Recom-binant human endostatin injection 150 mg added into 0.9%Sodium chloride injection 210 mL with portable micro pump for continu-ous pump of 120 h. A course involved 14 d treatment and 7 d interval. Short-term objective therapeutic efficacy,clinical benefit re-sponse (CBR) and ADR were evaluated after 2 courses. Disease progression time and average survival period were compared be-tween 2 groups. RESULTS:Objective response rate,disease control rate,disease progression time and average survival period of combination group were 14.6%,66.7%,(5.5 ± 1.3) months,(10.7 ± 3.8) months;those of control group were 8.7%,45.6%, (4.8±1.2)months,(8.9±3.3)months,with statistical significance between 2 groups(P0.05). CONCLUSIONS:S-1 combined with recombinant human end-ostatin show good therapeutic efficacy and tolerance for patients with middle and advanced primary liver carcinoma,and do not in-crease the incidence of ADR.
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Objective To evaluate the efficacy and safety of recombinant human endostatin (rh-endostatin) combined with cis-platinum for patients with malignant pleural effusions.Methods A computer-based online search was performed through Elsevier, PubMed, Medline, Cochrane Library, China National Knowledge Infrastructure (CNKI), Chinese BioMedical Literature Database and Wanfang Database.According to the inclusion and exclusion criteria, the randomized controlled trials about short-term therapeutic effect of rh-endostatin combined with cis-platinum on malignant pleural effusions published until December 2015 were selected.Quality of the studies was assessed using modified Jadad scale.After data extraction, a Meta-analysis was performed by RevMan 5.3 software.Relative risk (RR) and its 95% confidence interval (CI) were calculated.The Egger test was performed by Stata 12.0 software.Results Fourteen eligible randomized controlled trials were included in this Meta-analysis involving 1 330 patients,665 in cis-platinum alone group(control group), and 665 in rh-endostatin combined with cis-platinum group(treatment group).The results showed that there were significant improvements in overall response rate (ORR) [73.53% vs 45.41%,RR=1.62,95%CI(1.47,1.78),P<0.000 01] and the rate of quality of life improvement [71.65% vs 46.94%,RR=1.52,95%CI(1.38,1.68),P<0.000 01] in the treatment group, as compared with those of the control group.Meanwhile, there were no statistically significant differences in the rate of cardio toxicity [10.38% vs 5.77%,RR=1.73,95%CI(0.99,3.03),P=0.06].Conclusion This Meta-analysis indicated that in comparison with cis-platinum alone, rh-endostatin combined with cis-platinum has a better therapeutic effect on malignant pleural effusions.
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Objective To assess the antiangiogenic role of recombinant human endostatin combined with chemoradiotherapy and the capacity,and to explore the early tumor response as measured by comparing the change of MRI perfusion parameter.Methods From May 2012 to March 2013,22 locally advanced nasopharyngeal carcinoma patients who received recombinant human endostatin combined with chemoradiotherapy following induction chemotherapy,were included in the prospective study group.The other 25 patients,who received chemoradiotherapy following induction chemotherapy alone in the same period,were included in the control group.The perfusion parameters including blood volume(BV),blood flux(BF),mean transit time (MTT) were obtained by carrying out MR perfusion scanning at 3 time points:before induction chemotherapy,after induction chemotherapy,the end of concurrent chemoradiotherapy.Results Compared with before induction chemotherapy,the perfusion parameters including BV and BF obviously decreased in the study group (F =3.05,3.85,P ＜ 0.05).The parameter of MTT had no obviously change in the study group(P ＞0.05).In the control group,the change of BV,BF and MTT of nasopharyngeal lesions area during the treatment showed no significant difference (P ＞ 0.05).To make comparison between the two groups,at the end of concurrent chemoradiotherapy,BF of nasopharyngeal lesions area in the study group was 0.72 ± 0.56 and 1.92 ± 1.26 in the control group,the former showing significantly declined results (t =-3.056,P =0.012).Conclusions Recombinant human endostatin might be a good indicator of local tumor microvascular changes and the treatment-related toxicity could be tolerated.Magnetic resonance perfusion imaging maybe assessed the capacity of anti-angiogenesis therapy to induce early tumor response.Clinical trial registration Chinese clinical trial registry,ChiCRTONRC-12002394.
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OBJECTIVE:To observe clinical efficacy and safety of recombinant human endostatin(rh-endostatin)com-bined with CT-guided percutaneous microwave ablation in the treatment of non-small cell lung cancer(NSCLC)complicat-ed with chronic obstructive pulmonary disease (COPD). METHODS:A total of 80 cases of NSCLC complicated with COPD were selected from our hospital during Feb. 2014-Feb. 2016,and then divided into control group and observation group according to random number table,with 40 cases in each group. Control group was treated by CT-guided percutane-ous microwave ablation. Observation group was additionally given rh-endostatin injection 7.5 mg/m2,once a day,d1-14, added into 500 mL 0.9％ sodium chloride injection,ivgtt lasting for 4 h,for consecutive 14 d,on the basis of control group;7 d later,next course was performed. A treatment course lasted for 21 d,and they received 4 courses of treat-ment. Survival time,clinical efficacy as well as KPS score and lung function indexes before and after treatment,the oc-currence of ADR were compared between 2 groups. RESULTS:Median survival time of observation group(19.8 months) was significantly longer than that of control group(15.2 months),and total response rate of observation group(72.5％) was significantly higher than that of control group (55.0％),with statistical significance (P0.05). After treat-ment,KPS score and above lung function indexes levels of 2 groups were increased significantly,and those of observa-tion group were significantly higher than those of control group,with statistical significance (P0.05). CONCLUSIONS:rh-endostatin combined with CT-guided percutaneous microwave ablation in the treatment of NSCLC complicated with COPD show good clinical efficacy with less ADR,and can significantly improve lung function and quality of life.
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Objective To observe the efficacy and safety of pleural perfusion of recombinant human endostain ( endostar) combined with cisplatin ( DDP) in lung cancer patients with pleural effusion.Methods 80 patients with pleural effusion of lung cancer from January 2011 to December 2014 in our hospital were selected and randomly divided into the treatment group and the control group two groups with 40 cases in each group.Recombinant human endostain and DDP were injected into pleural cavity in the treatment group, the same dose of DDP was injected into the control group.Pleural effusion, KPS, Toxic and the exepress of vascular endothelial growth factor ( VEGF) of pleural effusion were measured before and after treatment. Results After treatment, the clinical efficacy of the observation group (RR), quality of life improvement rate and the level of VEGF in pleural effusion was significantly higher than that in the control group, the difference was statistically significant (P <0.05).The level of VEGF in Bloody pleural effusion was higher than in the non-bloody pleural effusion in the treatment group, there was significant difference (P<0.05).The observation group was higher than that of non hemorrhagic pleural effusion VEGF , the difference was statistically significant ( P <0.05 ) , both of them could lead to the decrease of VEGF level after treatmen, but there was no statistical significance between the two groups.Conclusion Clinical efficacy of intrapleural injection of recombinant human endostatin combined with cisplatin in patients with lung cancer complicated with pleural effusion, low adverse reaction, it is speculated that the recombinant human endostatin can inhibit the growth of tumor and the formation of pleural effusion by inhibiting the expression of VEGF in combination with cisplatin, it could effectively improve the quality of life of patients and prolong life.
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Objective To explore the efficacy of recombinant human endostatin ( Rh-endostatin ) com-bined with vinorelbine -cisplatin( NP) regimen for newly diagnosed patients with advanced non -small cell lung cancer(NSCLC)with bone metastases and the impact on expression of serum vascular endothelial growth factor (VEGF).Methods From January 1,2009 to February 1,2012,a total of 40 with newly diagnosed,advanced NSCLC patients with bone metastases were enrolled in this study and randomly assigned to the treatment (N=20) or control(N=20)group.The control group was only given the NP regimen chemotherapy and the treatment group was treated with Rh-endostatin combined with NP regimen .The changes in clinical effects of the two groups and serum VEGF levels were observed .Results After two cycles of systemic chemotherapy ,objective response rate (ORR)and disease control rate(DCR)of the treatment group were 30.0% and 80.0%significantly higher than 5.0%and 45.0%of the control group(P0.05).Conclusion Rh-endostatin combined with NP regimen can im-prove the efficiency of treatment for newly diagnosed patients with advanced NSCLC with bone metastases and does not increase adverse reactions whereas no significant difference in serum VEGF Levels .