阿帕替尼治疗老年晚期食管癌的临床疗效及安全性  

Clinical efficacy and safety of Apatinib in the treatment of advanced esophageal cancer in elderly patients

作　　者：马国军 李涛[1] 杜可[1] 邹胜鲁[1] 杨大伟 Ma Guojun;Li Tao;Du Ke;Zou Shenglu;Yang Dawei(Department of Thoracic Surgery , Liaocheng Peoples Hospital of Shandong Province , Liaocheng 252000,China;Zhong Yuan Academy of Biological Medicine Molecular Medicine Laboratory ,Liaocheng People's Hospital of Shandong Province ,Liaocheng 252000 ,China)

机构地区：[1]山东省聊城市人民医院胸外科,聊城252000 [2]山东省聊城市人民医院中原生物医学研究院分子医学实验室,聊城252000

出　　处：《中华老年医学杂志》2019年第4期412-415,共4页Chinese Journal of Geriatrics

基　　金：中国博士后科学基金(2015M580595).

摘　　要：目的探讨阿帕替尼治疗老年晚期食管癌患者的临床疗效、安全性及预后影响因素。 方法回顾性分析聊城市人民医院2015年3月~2017年8月符合入组条件的52例老年晚期食管癌患者,均给予阿帕替尼治疗,分析临床疗效、不良反应及预后影响因素。 结果患者部分缓解率为25.0%;疾病控制率为71.2%。不良反应主要有高血压(50.0%);手足综合征(38.5%);蛋白尿(36.5%)。不良反应程度主要为1~2级。患者中位无进展生存期(PFS)为3.8个月,中位总生存期(OS)为7.0个月。Log-Rank单因素分析提示不良反应程度(χ^2=5.075,P=0.024)、美国东部肿瘤协作组(ECOG)评分(χ^2=7.550,P=0.006)与老年晚期食管癌患者OS相关。Cox多因素回归分析提示不良反应程度(HR=1.963,P=0.045)和ECOG评分(HR=0.458,P=0.015)是影响老年晚期食管癌患者OS的独立因素。 结论阿帕替尼用于治疗老年晚期食管癌患者仍具有一定临床疗效,不良反应轻、安全性高。ECOG评分较低、不良反应程度较高的患者有较好的预后。Objective To investigate the clinical efficacy and safety of Apatinib in treating the advanced esophageal cancer and their prognosis in elderly patients. Methods Totally 52 elderly patients with advanced esophageal cancer who met the inclusion and exclusion criteria at our hospital from March 2015 to August 2017 were retrospectively enrolled.They were treated with Apatinib.The clinical efficacy, adverse reactions and influencing factors for the prognosis were analyzed. Results The partial remission rate(PRR)was 25.0% and the disease control rate(DCR)was 71.2% in 52 patients.The main adverse reactions were hypertension, hand-foot syndrome and proteinuria, with the incidence of 50.0%, 38.5% and 36.5%, respectively.The degree of adverse reactions was mainly grade 1~2.The median progression-free survival(PFS)was 3.8 months, and the median overall survival(OS)was 7.0 months.Univariate analysis(log-rank test)indicated that the degree of adverse reactions(χ^2=5.075, P=0.024)and the Eastern Cooperative Oncology Group(ECOG)score(χ^2=7.550, P=0.006)were associated with OS in elderly patients with advanced esophageal cancer.Cox multivariate regression analysis showed that the degree of adverse reactions(HR=1.963, P=0.045)and ECOG score(HR=0.458, P=0.015)were the independent influencing factors for OS in elderly patients with advanced esophageal cancer. Conclusions Due to mild adverse reactions and a high safety, Apatinib still has a certain clinical efficacy in the treatment of elderly patients with advanced esophageal cancer.Moreover, patients with the low ECOG score and high degree of adverse reactions have better prognosis.

关 键 词：食管肿瘤 血管生成抑制剂 

分 类 号：R735.1[医药卫生—肿瘤]