Clinical Research Of Anti-angiogenesis Drug Recombinant Human Endostatin To Determine Serum VEGF In Non-small Cell Lung Cancer

Non-small cell lung cancer(NSCLC) is one of the most common malignant tumor in our country,there is increased morbidity and mortality trends,seriously endangering the most people's health.Traditional surgery and chemotherapy have their own limitations,leading to the clinical treatment effect is not satisfied with,so people have been working hard at looking for an ideal tumor marker,with a view to enhance the rate of early diagnosis of NSCLC,and to monitor patients relapse and transfer of tumor.Serum vascular endothelial growth factor(Serum VEGF) can have a specific role in tumor vascular endothelial cells,promoting their proliferation and neovascularization.It has an important significance in the growth and metastasis of NSCLC.Objective:To explore the role and significance of Serum VEGF in patients with NSCLC.Methods:Serum VEGF was determined by sandwich enzyme linked immunosorbent assay(ELISA) in 69 patients with NSCLC and 20 healthy individuals.Results:Serum VEGF level in NSCLC(156.3±17.2)pg/ml was significantly elevated as compared with that in the controls(46.6±19.3) pg/ml(P=0.0000). No correlation was found between serum VEGF and gender,age,tumor size or the first-again treatment(P＞0.05).VEGF in squamous cell carcinoma was significantly higher than that in adenocarcinoma(P=0.0297),and serum VEGF was significantly higher in patients with distant metastasis than those without(P=0.0000).Serum VEGF level was closely related to the number of peripheral blood leukocytes, neutrophils and platelets(R=0.524,0.634 and 0.728).The level of VEGF was significantly elevated before radiotherapy,right after and after radiotherapy in the SD +PD group compared with the CR+PR group.Conclusions:Serum VEGF level is associated with tumor burden,tumor relapse and metastasis,and therapeutic effectiveness in patients with NSCLC. In recent years,the molecular targeted drugs have been a new hot spots to treat oncology,with inhibition of tumor angiogenesis into clinical trials and use.We hope they can improve the efficacy to break the status quo as a new method.RH-endostatin is a new type of biological production with broad-spectrum anti-angiogenesis effect, which can inhibit tumor growth,combined with chemotherapy more efficient and effectively to extend the survival time and improve life quality of patients with NSCLC,side effects of toxicity.By NCCN 2006,2007(Chinese version) recommended as first-line treatment of NSCLC status(newly diagnosed/recurrent).Objective:To observe and discuss the clinical value about RH-endostatin combined with three-dimensional conformal radiotherapy by detecting the sVEGF in NSCLC Patients dynamicly.Methods:30 patients were receiving radical 3DCRT when using RH-endostatin 7.5 mg·m~2,ivdrip,dl-d14,repeated after 7 days later.The serum VEGF was measured by sandwich enzyme linked immunoadsorbent assay(ELISA) in every cycle d1,d7 and d15,which was analized by SPSS 11.5 statistical package.Results:The response rate after 3DCRT was 83.3%(25/30),No statistically significant difference in the efficient related the pre-treat sVEGF level(P＞0.05);The sVEGF was continuing decline in clinical effective treatment(CR+PR);The change of sVEGF was not obvious or increased in clinical invalid patients(SD+PD);The sVEGF drop was significantly more in the high level group than the low level group(P＜0.05). The main adverse reactions about RH-endostatin were body weakness 40.0% (12/30),cardiac toxicity 6.7%(2/30)and rash 3.3%(1/30).The rate of improvement of clinical status was 86.7%(26/30),No cases with stageⅢor higher experienced severe adverse effects,with stageⅠ～Ⅱwell-tolerated.Conclusion:The sVEGF level change is a meaningful indicator associated with RH-endostatin united three-dimensional conformal radiotherapy in clinical application of NSCLC.