Short-term and long-term efficiency of cyclophosphamide metronomic chemotherapy combined with recombinant human endostatin in maintenance treatment of non-small cell lung adenocarcinoma

Zhang Wenyi

doi:10.3760/cma.j.issn.1673-4777.2015.05.007

Abstract：Objective To analyze the short-term and long-term efficiency of cyclophosphamide (CPA) metronomic chemotherapy (MET) combined with recombinant human endostatin (Endostar) in maintenance treatment of non-small cell lung adenocarcinoma (NSCLC).Methods Totally 86 patients of advanced NSCLC confirmed by pathology from January 2011 to January 2013 were enrolled.After 4 cycles of maximum tolerated dose of CPA,the patients were randomly divided into observation group receiving CPA MET combined with Endostar and control group receiving CPA MET only.After six weeks of maintenance treatment,the peripheral blood T cell subsets,cytokine levels,short-term and long-term clinical efficacy and adverse reaction were compared between the two groups.Results The serum soluble Fas (sFas) was significantly reduced,the Interferon (IFN)-γ,tumor necrosis factor (TNF)-α and interleukin (IL)-2 were significantly increased after 6 weeks of maintenance treatment,compared with those before treatment in both observation group [(4 892 ± 195) ng/L vs (6 102 ±205) ng/L,(15.2 ±2.4)％ vs (7.8 ±2.8)％,(7.7 ±2.2)％ vs (6.6 ±2.1)％,(11.3±1.7)％ vs (9.2±1.1)％] and control group [(5 816±201) ng/L vs (6 096 ± 199) ng/L,(5.5 ±2.4)％ vs (7.8 ±3.1)％,(7.4 ± 0.5)％ vs (6.6±1.5)％,(10.6±1.8)％ vs (9.2±1.4)％] (P＜0.05).After6 weeks of maintenance treatment,sFas was significantly lower,and IFN-γ,TNF-α,IL-2 levels were significantly higher in observation group compare with those in control group (all P ＜ 0.05).After 6 weeks of treatment,the effective rate in observation group was significantly higher than that in control group [35.7％ (15/42) vs 13.6％ (6/44),P ＜0.05].There were no significant differences regarding progression free survival and overall survival between the two groups (P ＞ 0.05).The incidence of adverse reactions in the two groups showed no significant difference (P =0.465).Conclusion CPA MET combined with endostar in maintenance treatment of NSCLC can significantly improve the immunity levels and the clinical efficacy.