阿帕替尼联合化疗治疗晚期乳腺癌的临床研究  

Clinical study of Apatinib combined with chemotherapy for advanced breast cancer

作　　者：黄世芬 燕冰雪 夏云霞 何方 赵成鹏[3] 张涛[2,3,4] 赵达[2,3,4] 令晓玲[2,3,4] Huang Shi-fen;Yan Bing-xue;Xia Yun-xia;He Fang;Zhao Cheng-peng;Zhang Tao;Zhao Da;Ling Xiao-ling(The First School of Clinical Medicine,Lanzhou University,Lanzhou 730000,China;Gansu Province Key Laboratory of Biotherapy and Regenerative Medicine,The First Hospital of Lanzhou University,Lanzhou 730000,China;Department of Oncology,The First Hospital of Lanzhou University,Lanzhou 730000,China;Donggang Hospital,The First Hospital of Lanzhou University,Lanzhou 730000,China)

机构地区：[1]兰州大学第一临床医学院,甘肃兰州7300002 [2]兰州大学第一医院甘肃省生物治疗与再生医学重点实验室,甘肃兰州730000 [3]兰州大学第一医院肿瘤内科,甘肃兰州730000 [4]兰州大学第一医院东岗院区,甘肃兰州730000

出　　处：《兰州大学学报（医学版）》2021年第1期52-58,共7页Journal of Lanzhou University（Medical Sciences）

基　　金：甘肃省生物治疗与再生医学重点实验室资助项目(zdsyskfkt-201706)。

摘　　要：目的评价阿帕替尼联合化疗治疗晚期多线乳腺癌患者的有效性和安全性。方法纳入兰州大学第一医院肿瘤内科2016年12月—2019年6月收治的2线及2线以上化疗失败晚期乳腺癌患者28例,给予阿帕替尼联合化疗,根据病情及既往用药情况选择化疗方案,分析阿帕替尼联合化疗客观缓解率、疾病控制率、无进展生存(PFS)以及不良反应发生情况。结果28例患者近期疗效评价提示无完全缓解,部分缓解为8例,疾病稳定为11例,疾病进展为9例;客观缓解率为28.6%(8/28),疾病控制率为67.9%(19/28)。4周期治疗前后肿瘤标志物差异有统计学意义(P<0.05)。远期疗效评价,PFS为2.0~18个月,中位PFS为4.4个月。治疗主要的毒副反应是高血压、蛋白尿、手足综合征、口腔黏膜溃疡、食欲不振、疲劳、腹泻和声音嘶哑等,大多数为1~2级,对症治疗后好转。4例(14.3%)出现3级以上口腔黏膜溃疡,8例(28.6%)出现3级以上高血压,2例(7.1%)出现声音嘶哑,均经减量及对症处理后好转。结论阿帕替尼联合化疗多线治疗晚期乳腺癌有较好的疗效且临床安全性好。Objective To evaluate the efficacy and safety of Apatinib combined with chemotherapy in patients with a multiline therapy of advanced breast cancer.Methods From December 2016 to June 2019,twenty-eight patients with advanced breast cancer,who had failed second-line or more and the chemotherapy and had been admitted to the Department of Oncology,the First Hospital of Lanzhou University,were included.The patients were administrated with Apatinib in combination with chemotherapy,and the chemotherapy regimen was selected based on the condition and previous medication to analyze the objective response rate,disease control rate, progress free survive(PFS) and adverse reactions of Apatinib combined with chemotherapy.Results The short-term efficacy evaluation of twenty-eight patients showed that no case of complete response,8 cases of partial response, 11 cases of stable disease and 9 cases of disease progression;the objectiveresponse rate was 28.6% (8/28), and the disease control rate was 67.9% (19/28). There were significant differencesin tumor markers before and after 4 cycles of treatment (P< 0.05). In the long-term efficacy evaluation,the PFS was 2.0 to 18 months, and the mPFS was 4.4 months. The main adverse reactions were hypertension,proteinuria, hand-foot syndrome, oral mucosa ulcer, poor appetite, fatigue, diarrhea and hoarseness, mostly ofgrade 1 to 2, and remission after symptomatic treatment. 4 cases (14.3%) developed grade 3 oral mucosaulcer, 8 cases (28.6%) grade 3 hypertension, and 2 cases (7.1%) hoarseness, and remission after drug reductionand symptomatic treatment. Conclusion Apatinib combined with chemotherapy for multi-line treatmentof advanced breast cancer has a better efficacy and clinical safety.

关 键 词：阿帕替尼 晚期乳腺癌 化疗 客观缓解率 无进展生存 

分 类 号：R737.9[医药卫生—肿瘤]