恩度微量泵持续给药联合化疗治疗晚期消化道肿瘤 的临床研究-肿瘤学专业论文.docxVIP

目 录 中文摘要 ·············································································1 英文摘要 ·············································································4 英文缩写 ·············································································8 研究论文 恩度微量泵持续给药联合化疗治疗晚期消化道肿瘤的临床 研究 前言 ·············································································9 材料与方法 ····································································10 结果 ·············································································14 附图 ·············································································18 附表 ·············································································25 讨论 ·············································································39 结论 ·············································································44 参考文献 ·······································································45 综述 重组人血管内皮抑制素治疗恶性肿瘤的研究进展 ···················47 致谢 ···················································································56 个人简历 ·············································································57 恩度微量泵持续给药联合化疗治疗晚期消化道肿瘤的临床研究 摘 要 目的：通过给予晚期消化道肿瘤患者重组人血管内皮抑制素注射液 （恩度，Endostar）微量泵持续给药及静脉滴注给药联合化疗对比贝伐单 抗（bevacizumab）联合化疗等不同治疗措施，并观察其近、远期疗效、 影响药物疗效的因素和不良反应，为抗血管靶向药物临床治疗晚期消化道 肿瘤患者优化给药方案提供依据。 方法： 1 筛选符合试验标准病例，共纳入 78 例经病理组织学和/或细胞学确 诊的局部晚期或复发转移性消化道恶性肿瘤患者的临床病例资料，包括食 管癌 3 例、胃癌 18 例、结肠癌 31 例、直肠癌 26 例，分为 4 组：A 组（恩 度泵入联合化疗组）、B 组（恩度静滴联合化疗组）、C 组（贝伐单抗联 合化疗组）和 D 组（单纯化疗组）。每种方案应用 2-3 周期后，根据 RECIST1.1 实体瘤疗效评价标准对四组进行疗效评价，比较四组之间及两 两之间的客观有效率（Objective Response Rate，ORR）、疾病控制率 （Disease Control Rate，DCR）、无进展生存期（Progression Free Survival， PFS）、总生存期（Overall Survival, OS）。同时根据性别、年龄、东部肿 瘤协作组（ Eastern Cooperative Oncology Group ， ECOG ） 身 体 状 况 （Performance Status ，PS）评分、体重指数（Body Mass Index，BMI）、 原发部位、治疗史（原发病手术史、放疗史、化疗史）、有无慢性病（高 血压病、冠心病）、转移器官数目、治疗线数等几方面进行组内和组间亚 组分析，从而了解影响药物疗效的因素。根据 WHO 化疗毒副反应分级 标准对病例进行统计，对四组进行包括血液学毒性、肝肾毒性、心脏毒性 等在内的毒副作用情况比较，