阿帕替尼在晚期胃癌真实世界治疗中的疗效及安全性分析  

Efficacy and safety analysis of apatinib in the real-world treatment of metastatic gastric cancer

作　　者：周建红[1] 陈海辉[1] 黄海欣[1] 陈绍俊[1] 罗文苹[1] 华丽[1] 刘春琳[1] Zhou Jianhong;Chen Haihui;Huang Haixin;Chen Shaojun;Luo Wenping;Hua Li;Liu Chunlin(Department of Oncology,Fourth Affiliated Hospital of Guangxi Medical University,Guangxi Liuzhou 545005,China.)

机构地区：[1]广西医科大学第四附属医院肿瘤科

出　　处：《现代肿瘤医学》2020年第2期264-267,共4页Journal of Modern Oncology

基　　金：广西壮族自治区卫生和计划生育委员会自筹经费科研课题(编号:Z20180505)

摘　　要：目的:了解阿帕替尼在晚期胃癌真实世界中的疗效及安全性,分析影响阿帕替尼疗效的因素。方法:选取2014年11月至2018年5月在我院使用阿帕替尼的晚期胃癌患者。所有患者至少完整使用阿帕替尼1周期,剂量范围250 mg^850 mg,并有疗效及安全性的评估记录。用RECIST 1.1和CTCAE 4.0标准评估患者疗效及不良反应。结果:共52例患者纳入分析,中位年龄65岁(年龄范围35~89岁)。提前(≤2线)使用阿帕替尼的患者共38例,占73.1%;PS评分≥2分得患者共8例,占15.4%。使用阿帕替尼治疗有效率(PR)9.6%,疾病控制率(DCR)55.8%。单因素分析显示年龄大(≥65岁)(P=0.028)、≤2线使用(P=0.037)和非肿瘤科使用(P=0.016)与阿帕替尼疗效更好有关。98.07%的患者在治疗过程中出现不同程度的药物相关性不良反应。最常见的III-IV度毒副反应为为手足综合征(9.6%)、白细胞下降(5.8%)和蛋白尿(5.8%),没有因药物相关性毒副反应而死亡的患者。结论:阿帕替尼在晚期胃癌真实世界治疗中是安全的。患者越早使用阿帕替尼,越能从阿帕替尼的治疗中获益。Objective:To understand the efficacy and safety of apatinib in the real-world treatment of metastatic gastric cancer,and to analyze the factors that affect the efficacy of apatinib.Methods:We collected patients with metastatic gastric cancer who used apatinib in our hospital from November 2014 to May 2018.All patients had at least one cycle apatinib,with dose range from 250 mg to 850 mg,and a record of efficacy and safety assessments.Response Evaluation Criteria in Solid Tumors,version 1.1 and Common Terminology Criteria for Adverse Events,version 4.0 were used to evaluate efficacy and adverse effects.Results:A total of 52 patients were included in the analysis,with a median age of 65 years(range,35~89 years).Patients who early(less than 2 lines)used apatinib were 38 cases,accounting for 73.1%.the PS score was more than 2 shared a total of 8 patients,accounting for 15.4%.The partial response(PR)using apatinib treatment was 9.6%,and the disease control rate was 55.8%.The single factor analysis showed that older age(over 65 years)(P=0.028),less than 2 lines(P=0.037)and use of non-Oncology department(P=0.016)are associated with better efficacy.98.07%of patients had different levels of drug-related adverse reactions in the course of treatment.The most common III-IV grade toxicity reactions were hand-foot syndrome(9.6%),leukopenia(5.8%)and proteinuria(5.8%),and there were no deaths due to drug-related adverse effects.Conclusion:Apatinib is safe in real-world treatment for metastatic gastric cancer.Patients with earlier use of apatinib,benefit more.

关 键 词：阿帕替尼 胃肿瘤 不良反应 真实世界 治疗疗效 

分 类 号：R735.2[医药卫生—肿瘤]