Application of recombinant human endostatin combined with radiotherapy in treating non-small cell lung cancer with brain metastases and screening of eligible patients

To evaluate the clinical efficacy of recombinant human endostatin combined with radiotherapy on brain metastases from non-small cell lung cancer and screen the patients who were eligible for this therapy. Eighty patients diagnosed with lung cancer with brain metastasis were randomly divided into the combination group (recombinant human endostatin combined with radiotherapy) and radiotherapy alone group (n=40 for each group). The short-term efficacy, overall survival time, cerebral edema index and adverse reactions were observed. In addition, the expression levels of vascular endothelial growth factor receptor 2 (VEGFR2) protein in primary lesions were detected by using immunohistochemical analysis. All these indexes were subject to subgroup analysis. Compared with alone radiotherapy group, the symptom of brain edema was significantly alleviated (t=4.9, P=0.000) and no severe adverse reactions were yielded in the combination group. The short-term clinical efficacy was enhanced in total population (n=80), whereas no statistical significance was noted (55% vs. 50%, χ2=3.11, P=0.07). However, there was statistical significance in the patients with positive VEGFR2 (93% vs. 67.7%, χ2=6.21, P=0.011) in terms of short-term clinical efficacy. Regarding overall survival time, there was no statistical significance in the total population (n=80, P=0.35, 95% CI: 0.23-1.31) or in the patients with positive VEGFR2 (P=0.109, 95% CI: 0.44-1.35). No clinical benefits were obtained in terms of median survival time. Compared with radiotherapy alone, recombinant human endostatin combined with radiotherapy can relieve brain edema in the patients with lung cancer with brain metastasis and obtain better short-term clinical efficacy in the population with positive VEGFR2.