摘要
目的探讨重组人血管内皮抑制素(恩度)联合化疗治疗儿童神经母细胞瘤(NB)伴脑转移的临床疗效及安全性。方法回顾性分析首都医科大学附属北京同仁医院儿科中心2015—2020年间收治的NB伴脑实质转移患儿共30例的临床资料,并分为观察组和对照组,每组15例。对照组采取化疗,观察组在化疗基础上加用重组人血管内皮抑制素治疗,比较两组的临床疗效及药物安全性。结果观察组治疗有效率为40%(6/15),高于对照组的20%(3/15),但两组比较无明显差异(P=0.232);16例VEGF表达阳性者中观察组治疗有效率为5/9,高于对照组的2/7,但两组比较无明显差异(P=0.280)。中位随访时间14个月,观察组2年总生存率为61%,与对照组的49%相近(P=0.348);VEGF表达阳性者两组预后不同(P=0.030)。两组不良反应多轻微且相近(均P>0.05)。结论重组人血管内皮抑制素联合化疗对儿童NB伴脑转移近期临床疗效的提高可能有一定治疗效果,对于VEGF表达阳性者或能有效改善预后,不良反应少。该研究结论还需大样本研究加以证实。
Objective To investigate the clinical efficacy and safety of recombinant human endostatin(RHE)combined with chemotherapy in the treatment of children with neuroblastoma with brain metastasis.Methods The clinical data of 30 children with neuroblastoma and brain parenchymal metastasis admitted to our center from January 2015 to January 2020 were collected and randomly divided into observation group and control group,with 15 cases in each group.The control group was treated with chemotherapy,while the observation group was treated with RHE on the basis of chemotherapy in the control group.The clinical efficacy and drug safety of the two groups were compared.Results The effective rate of the observation group was 40%(6/15),which was higher than that of the control group(20%,3/15),but there was no significant difference between the two groups(P=0.232).Among the 16 cases with positive VEGF expression,the effective rate of the observation group was 5/9,which was higher than that of the control group(2/7),but there was no significant difference between the two groups(P=0.280).The median follow-up time of 14 months,the 2-year overall survival rate of the observation group was 61%,which was similar to the control group(P=0.348);For children with positive VEGF expression,the prognosis of the two groups was statistically different(P=0.030).The adverse reactions between the two groups were mostly mild and with no significant statistical difference(P>0.05).Conclusion RHE combined with chemotherapy in the treatment of child neuroblastoma with brain metastasis can possibly improve the short-term clinical efficacy,and may improve the overall survival and prognosis of patients with positive expression of VEGF,with fewer adverse reactions.A large sample study is still needed to confirm the conclusion.
作者
支天
张伟令
张谊
王一卓
胡慧敏
黄东生
Zhi Tian;Zhang Weiling;Zhang Yi;Wang Yizhuo;Hu Huimin;Huang Dongsheng(Department of Pediatrics,Beijing Tongren Hospital Affiliated to Capital Medical University,Beiiing 100176,China)
出处
《中华转移性肿瘤杂志》
2022年第4期312-316,共5页
Chinese Journal of Metastatic Cancer
