ObjectiveTo observe the clinical efficacy of recombinant human endostatin injection (Endo) combined with radiotherapy in the treatment of elderly patients with advanced nasopharyngeal carcinoma and the effects on vascular endothelial growth factor (VEGF), vascular endothelial growth factor receptor2 (VEGFR2) and platelet reactive protein1 (TSP1).Methods80 cases of elderly patients with advanced nasopharyngeal carcinoma were selected as the research object,who were admitted to Foshan First People's Hospital from January 2016 to June 2018. They were randomly divided into two groups, the control group 40 cases with radiotherapy and chemotherapy, the observation group 40 cases radiotherapy combined the treatment of human recombinant endostatin injection. The clinical efficacy of the patients in two groups was observed according to the expression levels of VEGF, VEGFR2 and TSP1 in serum of all patients by enzymelinked immunosorbent assay (ELISA), and the changes of various indexes before and after treatment were compared.ResultsThere was no significant difference between the control group and the observation group(P＞0.05), and their total effective rate was 100% including complete response (CR) and partial response(PR). The incidence of adverse reactions such as nausea and vomiting, III~IV mucositis, leukocyte and thrombocytopenia in the observation group were significantly lower than those in the control group (P<0.05). Serum VEGF and VEGFR2 levels were significantly decreased in both groups, while TSP1 levels were significantly increased, which were statistically significant for those after treatment compared with those before treatment(P<0.05).Comparing between the groups, the levels of VEGF and VEGFR2 in the serum of the observation group were significantly lower than those in the serum of the control group, and the difference was statistically significant (P<0.05).There were significant differences between the serum VEGF, VEGFR2, TSP1 levels of III patients and those of IV patients by aTNMclassification before treatment in the observation group (P<0.05). Treatment decreased serum levels of VEGF and VEGFR2, and increased serum level of TSP1 more significantly in IV patients compared to Ⅲ patients. In the observation group, VEGF was positively correlated with VEGFR2 (r=0.642, P=0.002), while VEGF and VEGFR2 were negatively correlated with TSP1 (r=-0.389, P<0.001)； r=-0. 652, P<0.001).ConclusionsRecombinant human endostatin combined with radiotherapy can achieve the same shortterm efficacy as conventional concurrent chemoradiotherapy. The treatment reduce the incidence of adverse reactions, and improve the serum levels of VEGF, VEGFR2 and TSP1. Especially the curative effect is more obviously in Ⅳ patients.