胃癌三线阿帕替尼不同起始剂量和预后相关指标的临床研究  

Clinical Study on Different Initial Dose of Apatinib and Prognostic Indexes in Third-line Gastric Cancer Patients

作　　者：朱琳[1] 黄英[1] 曲雁红[1] 薛红[1] 曲美华[1] 潘春霞[1] 张廷梅[1] ZHU Lin;HUANG Ying;QU Yan-hong;XUE Hong;QU Mei-hua;PAN Chun-xia;ZHANG Yan-mei(Department of Oncology,Dalian Third People's Hospital,Dalian 116033,China)

机构地区：[1]大连市第三人民医院肿瘤内科,辽宁大连116033

出　　处：《中国医药指南》2020年第13期42-43,46,共3页Guide of China Medicine

基　　金：大连市医学科学研究计划项目(课题编号:1811052)

摘　　要：目的探讨胃癌三线不同起始剂量阿帕替尼的疗效及不良反应,及血清VEGFR-2可能是疗效预测指标。方法入组40例患者随机分配至250 mg组和500 mg组阿帕替尼起始剂量组中。在应用阿帕替尼前进行CT检查,并抽取患者的外周血,留取尿液,检测外周血白细胞计数,粒细胞计数,血小板计数,生化系列,血清VEGFR-2浓度以及尿蛋白。两组患者接受4周治疗后,比较两组的临床疗效、不良反应,并监测用药后血清VEGFR-2浓度的变化与PFS的关系。结果阿帕替尼250 mg组疾病控制率(CR+PR+SD)10例(50.00%),阿帕替尼500 mg组疾病控制(CR+PR+SD)2例(60.00%)。两组疾病控制率无明显差异,P>0.05。阿帕替尼的不良反应主要体现在乏力,血液学毒性,蛋白尿和高血压,阿帕替尼250 mg组不良反应发生率较阿帕替尼500 mg组发生率低,P<0.05。用药后VEGFR-2浓度降低幅度越大,PFS明显延长。结论胃癌三线阿帕替尼的治疗,250 mg起始剂量与500 mg起始剂量相比较临床疗效无明显差别但不良反应更小,血清VEGFR-2可能成为胃癌三线阿帕替尼治疗潜在近期疗效预测指标。Objective To investigate the efficacy and adverse reactions of apatinib at different starting doses in third-line gastric cancer patients.Serum VEGFR-2 may be a predictor of efficacy.Methods Forty enrolled patients were randomly assigned to two groups with different starting doses of apatinib,namely the 250 mg starting dose group and the 500 mg starting dose group.CT examination,blood routine,biochemical series,Serum VEGFR-2 concentrationand,urine routine should be done before the application of apatinib.After 4 weeks of treatment,the clinical efficacy and adverse reactions of the two groups were compared.The relationship between PFS and serum vegfr-2 concentration was also monitored.Results The disease control rate(CR+PR+SD)was 10(50.00%)in the 250 mg group of apatinib and 12(60.00%)in the 500 mg group of apatinib.There was no significant difference in the disease control rate between the two groups,P>0.05.The adverse reactions of apatinib were mainly manifested in fatigue,hematological toxicity,proteinuria and hypertension.The incidence of adverse reactions in the 250 mg apatinib group was lower than that in the 500 mg apatinib group(P<0.05).PFS was significantly prolonged after treatment with VEGFR-2.Conclusion Third line administration of 250 mg low-dose apatinib for gastric cancer has a clear clinical effect with less adverse reactions.Serum VEGFR-2 may be a predictor of the potential short-term efficacy of third-line apatinib therapy for gastric cancer.

关 键 词：胃癌 血管内皮生长因子受体-2 阿帕替尼 

分 类 号：R735.2[医药卫生—肿瘤]