| ObjectiveTo observe the clinical effects and changes of coagulation function indexes on which Low-molecular-weight Heparin plays a role in patients with non-small cell lung cancer (NSCLC).MethodsWe adopted prospective trial research methods, followed the randomized and controlled principle. Seventy-two patients with III or IV stage elderly non-small cell lung cancer were enrolled from the respiratory department in Shandong Provincial Hospital affiliated to Shandong University and they were randomly divided into observation group (Low-molecular-weight Heparin group) and control group.36 cases in observation group and 36 cases in control group. Patients in control group were treated with the first-line chemotherapy and symptomatic treatment, patients in the observation group were treated with Low-molecular-weight Heparin (5000 iu ih qd) based on the treatment control group patients received. Patients in observation group received Low-molecular-weight Heparin therapy from 3 days before chemotherapy to 4 days after chemotherapy, seven days for a period of treatment. We observed and evaluated the coagulation function indexes (four coagulation tests、D-dimer、platelet) and clinical effect after two courses treatment. Coagulation function indexes were detected in all cases before and after 2 cycles of chemotherapy, clinical effect evaluation included objective therapeutic effect of tumors、comparison of KPS score before and after treatment、incidence of adverse reactions. The collected data underwent statistical analysis to compare the difference between results from the two groups.ResultsIn this study, a total of 72 patients were included,2 of them withdrew from, and 70 patients completed the study,35 patients in each group.The basic data compared with the observation and control group showed no statistical significance before treatment, they were completely comparable. Clotting properties were abnormal in different degrees in both groups, difference was not statistical significance. The coagulation function indexes were compared before and after treatment in each group. APTT、PT had no significant changes, TT slightly prolonged; platelet, fibrinogen, D-dimer were improved in observation group, difference had statistical significant (P<0.05); while there were higher levels of D-dimer and platelet(P<0.05), the rest had no changes in the control group, difference had no statistical significance(P>0.05). Comparison of TT, Platelet, fibrinogen, D-dimer after treatment between two groups, the difference was significant (P< 0.05).Clinical efficacy assessment includes:1, objective therapeutic effect of tumors: the total effective rate of observation group was 25.71%, the total effective rate of control group was 17.14%; the disease control rate of observation group was 91.43%, the disease control rate of control group was 82.86%. There was no statistical significant between two groups (P>0.05).2, KPS score:KPS score was similar in the observation group before and after two cycles treatment, showed no statistical significance (P>0.05); KPS score decreased after treatment compared with that before treatment in control group, difference was significant (P< 0.05). By Comparing two groups data after treatment, KPS score of observation group was higher than control group (P<0.05).KPS score evaluation between two groups, observation group KPS score evaluation:(improve+ stable) percentage is 88.57%; control group KPS score evaluation:(improve+stable) percentage is 60.00%, there were statistical differences (P< 0.05).Safety evaluation:comparison of anticancer-drug-related reactions between two groups, showed no statistical significance; there was one adverse reaction case (slight subcutaneous bleeding symptoms) associated with Low-molecular-weight Heparin in observation group, the symptoms had relieved after replacing the injection site. There was no severe reaction leading to the termination of clinical study of two groups.Conclusion1. Low-molecular-weight Heparin can improve the coagulation indexes in patients with advanced non-small cell lung cancer;2. Low-molecular-weight Heparin can improve quality of life in patients under chemotherapy (KPS score);3. Low-molecular-weight Heparin shows no significant advantage in objective therapeutic effect of tumors.4. There was no severe side effect during the Low-molecular-weight Heparin treatment.5. What role of Low-molecular-weight Heparin plays in the adjuvant therapy of patients with advanced non-small cell lung cancer? It is still not clear. The effects of improving survival time、inhibiting of tumor growth still needed more large sample sizes, multi-center, randomized, controlled trial to further research and exploration. |
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