Clinical Observation On Recombinant Human Vascular Endostatin Combined Wihch Emotherapy In The Treatment Of A Variety Of Advanced Malignancies And Effectin The Serum Level Of Vascular Endothelial Growth Factor(VEGF)

BackgroundAdvanced tumor patients were previously treated with the comprehensive treatment such as surgery, radiation and chemotherapy of tumor, but after surgery, radiation and chemotherapy, the tumor always relapse and metastasis. This state will decrease the patient’s resection rate and the5-year survival rate, so the clinical treatment with combination chemotherapy is given to the advanced tumor patients, but the effect of the clinical treatment is unsatisfactory. In recent years, the anti-tumor angiogenesis therapy that developed for the tumor invasion and metastasis is becoming an important research field. The human recombinant endostatin (degrees, endostar), developed by our country, was used to be used in clinical treatment of advanced non-small cell lung cancer. After a few days, studies in vitro have shown that not only for the non-small cell carcinoma is significantly effective, but also is effective for the other tumors. At present, more and more scholars think that the anti-angiogenesis target therapy combined with the chemtherapy can possible prolong the survival time of the patient.In this study, by investigating the efficacy and safety of the endostar (human recombinant endostatin injection, endostar) combined with the the chemotherapy treatment to cure a variety of middle-late malignant tumors, and compare the expression level of the VEGF in the serum before and after the treatment, and preliminary investigate whether the VEGF can become the effective predictor of the advanced malignant tumor anti-angiogenic target therapy.Objective:1.To investigate the clinical efficacy and safety of recombinant human endostatin injection combined with chemotherapy in the treatment of a variety of advanced malignancies.2.To compare the expression of the tumor angiogenesis factor VEGF before and after the treatment, and find the effective predictor for the advanced malignant tumor target angiogenic therapy.Method:1.158cases of patients with advanced cancer and histopathology confirmed ⅢB-Ⅳ were selected and divided into two parts with the principle of randomization,79cases in chemotherapy group and79cases chemotherapy combined with endostar group. The chemotherapy of the two groups is almost the same to each. After two cycles of the treatment, the clinical efficacy of the two groups and quality of life of patients were analyzed.2.The change of expression level of the VEGF protein in peripheral venous blood was measured with ELISA before treatment and after two cycles of chemotherapy in both of the endostar combined with chemotherapy treatment group and the chemotherapy alone treatment group.Result:1.chemotherapy+endostar Group:complete remission in15cases, partial remission in31cases, stability of the21cases, progress in12cases, total effective rate was58.2%; chemotherapy group:5cases of complete remission, partial remission in23cases,19cases of stability, progress32cases, total effective rate of35.4%, the two groups total effective rate, the difference was statistically significant (P<0.05);2.the chemotherapy+endostar group36cases (45.6%) patients quality of life (QOL) improvement27cases (34.2%) QOL stable decline in16cases (20.2%) QOL; chemotherapy group and20patients (25.3%) patients QOL improvement,26cases (32.9%) QOL stable decline in33cases (41.8%) QOL improvement rate of the two groups were statistically compare the difference was statistically significant (P<0.05);3.major adverse reaction of the chemotherapy+endostar group and thechemotherapy group leukopenia, thrombocytopenia, nausea, vomiting, fatigue, weakness, were statistically In comparison, the differences between the two sets of adverse reactions was not statistically significant (P>0.05).4. The levels of VEGF were significantly decreased in both the chemotherapy+endostar group and the chemotherapy group and the chemotherapy+endostar group was even higher than the chemotherapy group (P<0.05).Conclusion:1.Endostar is used in combination with the chemotherapy drug can effectively control and delay in a variety of advanced cancer disease progression, especially in advanced esophageal cancer, and significantly improve the quality of life of cancer patients, and low toxicity, safe, and worthy of further clinical study.2. After the treatment of Endostar combination with the chemotherapy drug, the levels of VEGF can be significantly inhibited.