替吉奥联合阿帕替尼三线治疗晚期肠癌患者的临床观察  

Clinical analysis of third-line combination therapy with S-1 plus apatinib for advanced colorectal cancer

作　　者：戴宇翃[1] 孙黎[1] 黄婷婷[1] 邱红[1] Yuhong Dai;Li Sun;Tingting Huang;Hong Qiu(Department of Gastrointestinal Oncology,Tongji Hospital Cancer Center,Tongji Medical College,Huazhong University of Science&Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院肿瘤中心消化系统肿瘤科

出　　处：《中国肿瘤临床》2019年第18期945-948,共4页Chinese Journal of Clinical Oncology

摘　　要：目的:观察替吉奥联合阿帕替尼用于晚期肠癌三线治疗的疗效和安全性。方法:回顾性分析2016年4月至2018年8月华中科技大学同济医学院附属同济医院收治的44例采用替吉奥联合阿帕替尼治疗的三线肠癌患者临床病例资料,并进行随访,记录药物使用的有效性及不良反应数据。结果:全组44例患者中位无进展时间(median progression-free survival time,mPFS)为3.93(2.72~5.15)个月,中位生存时间(median overall survival time,mOS)为7.77(5.36~10.18)个月。左半结肠及直肠癌患者mPFS为4.94个月,右半结肠癌患者mPFS为3.89个月,两组比较差异有统计学意义(P=0.024);左半结肠及直肠癌患者mOS为12.5个月,右半结肠癌患者mOS为7.40个月,两组比较差异无统计学意义(P=0.080);性别、既往是否使用过贝伐单抗以及是否存在肝转移对于mPFS及mOS无显著影响;初始治疗时ECOG评分0~1分及2分的患者mPFS分别为4.48个月及1.10个月(P<0.001),mOS分别为9.67个月及2.90个月,两组比较差异均有统计学意义(P<0.001)。治疗相关性不良反应最普遍的为乏力(52.3%),其次为高血压(45%)、手足综合征(22.7%)、蛋白尿(15.9%)、白细胞下降(15.9%)、血小板下降(22.7%)、转氨酶升高(13.6%)、腹泻(15.9%)。结论:替吉奥联合阿帕替尼用于肠癌的三线治疗具有较好的疗效,不良反应方面安全可耐受。Objective: To investigate the efficacy and toxicity of apatinib combined with S1 as a third-line therapy for advanced colorectal cancer. Methods: Forty-four patients with adavanced colorectal cancer from Tongji Hospital Cancer Center were enrolled from April 2016 to August 2018. The median follow-up period was 8 months. Data related to efficacy and adverse effects were recorded. Results: The median progression-free survival(PFS) time was 3.93 months(95%CI: 2.72-5.15 months), and the median overall survival(OS) time was 7.77 months(95%CI: 5.36-10.18 months). Patients with left hemicolon cancer and rectal cancer group had a longer PFS than patients with right hemicolon cancer group(4.94 months vs. 3.89 months, P=0.024);the OS for left hemicolon cancer and rectal cancer was 12.5 months, the OS for right hemicolon cancer was 7.4 months, P=0.080;gender, previous bevacizumab use and liver metastasis had no statistically significant effect on PFS and OS;the PFS was 4.48 months and 1.10 month, in the patients with ECOG 0-1 and ECOG 2;the OS was 9.67 months and 2.90 month, in these two groups respectively. The major adverse effects of the combination therapy were fatigue(52.3%), hypertension(45%),hand-foot syndrome(22.7%), leukopenia(15.9%), and neutropenia(15.9%), thrombocytopenia(22.7%), elevated transaminase levels(13.6%),diarrhea(15.9%). Conclusions: The results suggest that the combination of apatinib and S-1 is safe and effective as a third-line treatment for advanced colorectal cancer.

关 键 词：肠癌 替吉奥 阿帕替尼 不良反应 临床观察 

分 类 号：R73[医药卫生—肿瘤]