阿帕替尼治疗晚期进展性头颈部鳞癌的可行性和安全性  

Efficacy and safety of apatinib treatment for advanced progressive head and neck squamous cell carcinoma

作　　者：李兰 郎锦义[2] 周鹏程 潘媛媛 梁天嵩 杨道科[1] LI Lan;LANG Jinyi;ZHOU Pengcheng;PAN Yuanyuan;LIANG Tiansong;YANG Daoke(Department of Radiotherapy,First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan Province,China;Radiotherapy Center,Sichuan Cancer Hospital,Chengdu 610041,Sichuan Province,China)

机构地区：[1]郑州大学第一附属医院放疗科,河南郑州450052 [2]四川省肿瘤医院放疗中心,四川成都610041

出　　处：《肿瘤》2019年第12期1011-1018,共8页Tumor

摘　　要：目的:评价阿帕替尼联合个体化放化疗治疗晚期头颈部鳞癌的有效性和安全性。方法:回顾性分析郑州大学第一附属医院2017年-2018年收治的44例晚期进展性头颈部鳞癌患者的临床资料。所有患者给予阿帕替尼单药500 mg,1次/d,至疾病进展;期间出现不耐受时减量为250mg,1次/d;同期联合个体化放疗或化疗,对复发病灶或转移灶进行局部调强放射治疗(intensity modulated radiation therapy,IMRT),化疗采用同步铂类+氟尿嘧啶或紫杉醇类+铂类或紫杉醇类+氟尿嘧啶+铂类。观察临床疗效和不良反应。结果:44例晚期进展性头颈部鳞癌患者中无完全缓解者,部分缓解者9例(20.45%),疾病稳定者22例(50.00%),疾病进展者13例(29.55%),客观反应率为20.45%,疾病控制率为70.45%,中位无进展生存时间为5个月(95%置信区间:3.26~6.74)。所有患者均对阿帕替尼耐受良好,无任何3级或4级不良反应;最常见的不良反应为口腔溃疡29例(65.91%)、肝功能异常16例(36.36%)和头痛13例(29.55%)。结论:阿帕替尼联合个体化放疗或化疗治疗晚期进展性头颈部鳞癌患者具有可行性,其安全性可控。Objective: To evaluate the efficacy and safety of apatinib combined with individualized chemoradiotherapy for advanced progressive head and neck squamous cell carcinoma(HNSCC).Methods: A retrospectively analysis was performed by using the clinical data of 44 patients with advanced progressive HNSCC who were admitted in the First Affiliated Hospital of Zhengzhou University from 2017 to 2018. All patients were treated with apatinib 500 mg once a day until the disease progressed. During the treatment period, if the patient was intolerant to the toxicity of the drug, the dose of apatinib was reduced to 250 mg once a day. At the same time, all patients were treated with individualized radiotherapy or chemotherapy. Intensity modulated radiation therapy(IMRT) was used for the recurrent or metastatic lesions. The chemotherapy regimen was synchronous platinum + fluorouracil or paclitaxel + platinum or paclitaxel + fluorouracil + platinum. The clinical efficacy and adverse reactions were observed.Results: Among 44 patients with advanced progressive HNSCC, there was no complete remission, 9(20.45%) patients with partial remission, 22(50.00%) patients with stable disease, and 13(29.55%) patients with disease progression. The objective response rate was 20.45%, the disease control rate was 70.45%, and the median progression-free time was 5 months(95% confidence interval: 3.26-6.74). All patients were well tolerated to apatinib without any grade 3 or 4 adverse events. The most common adverse reactions were oral ulcers in 29(65.91%) cases, liver function abnormalities in 16(36.36%) cases, and headache in 13(29.55%) cases.Conclusion: The application of apatinib combind with individualized radiotherapy or chemotherapy for the patients with advanced progressive HNSCC is feasible, and its safety is controllable.

关 键 词：头颈部肿瘤 治疗结果 药物相关性副作用和不良反应 阿帕替尼 

分 类 号：R739.91[医药卫生—肿瘤]