阿帕替尼治疗化疗失败的晚期肺腺癌近期效果观察  

Recent clinical observation in treatment of chemotherapy-failed advanced lung adenocarcinoma cases with apatinib

作　　者：李磊[1] 张卫东[1] 王旭晖[1] 李晓平[1] 

机构地区：[1]天津市第一中心医院胸外科,300192

出　　处：《中国综合临床》2016年第10期917-920,共4页Clinical Medicine of China

摘　　要：目的：观察甲磺酸阿帕替尼治疗化疗失败的晚期肺腺癌的临床疗效及毒副反应。方法22例患者接受甲磺酸阿帕替尼治疗，初始剂量为425 mg／d，若无严重不良反应，服药2周后增量至675 mg／d，并维持治疗，通过影像学检查、CEA、NSE结果评价近期疗效。结果22例接受甲磺酸阿帕替尼治疗的患者中，完全缓解（CR）0例，部分缓解（PR）5例，稳定（SD）13例，进展（PD）3例，因严重不良反应停药1例，客观有效率23．8％（5／21），疾病控率85．7％（18／21）。治疗4周后血清CEA[（97．45±79．05） mg／L与（47．05±31．89） mg／L]及NSE[（20．27±6．88） mg／L与（11．09±8．92） mg／L]较前均有明显下降，差异均有统计学意义（ t值分别为2．45、3．56，P均＜0．05）。肿瘤不同转移部位对预后影响均无统计学意义（ P均＞0．05）。不良反应主要是高血压及蛋白尿发生率分别为72．7％、59．0％。结论甲磺酸阿帕替尼治疗化疗失败的晚期肺腺癌近期疗效较好，毒副反应可控制，可在临床使用并研究其长期疗效。Objective To analyze the treatment of chemotherapy-failed advanced lung adenocarcinoma cases and the adverse reactions with apatinib. Method Twenty-two patients received treatment of apatinib at a dose of 425 mg/day for two weeks,then at a dose of 675 mg/day for two weeks if could be tolerated. The efficacy was evaluated by the imaging,CEA and NSE. Results The clinical evaluation of patients were complete remis-sion（ CR） 0 case,partial remission（ PR） 5 cases,steady（ SD） 13 cases,progress（ PD） 3 cases,1 case termina-ted the treatment due to adverse reactions,and the objective response rate was 23. 8%（5/21）,disease control rate was 85. 7%（18/21）. After 4 weeks treatment,CEA and NSE were significantly reduced than the previous （（97. 45±79. 05） mg/L vs. （47. 05±31. 89） mg/L,（20. 27±6. 88） mg/L vs. （11. 09±8. 92） mg/L;t=2. 45, 3. 56;P〈0. 05） . The impacts on prognosis of different metastatic sites were no statistical significant difference（ P〉0. 05） . The main side effects were hypertension and proteinuria（ 72. 7%,59. 0%） . Conclusion The treatment of chemotherapy-failed advanced lung adenocarcinoma with apatinib has better exact effect,and toxicity could be controlled,so it was worthy of clinical treatment and evaluation of long-term efficacy.

关 键 词：甲磺酸阿帕替尼 肺腺癌 临床疗效 毒副反应 

分 类 号：R734.2[医药卫生—肿瘤]