安罗替尼联合伊立替康方案二线治疗晚期复发难治性小细胞肺癌的临床疗效观察  

Effect of anlotinib combined with irinotecan in the second-line treatment of advanced relapsed and refractory small cell lung cancer

作　　者：姬颖华[1] 杨晓煜[2] 王瑾 孟祥丽[1] 张景航[3] JI Yinghua;YANG Xiaoyu;WANG Jin;MENG Xiangli;ZHANG Jinghang(Depatment of Oncology,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,Henan Province,China;Pathological Teaching and Research Office,School of Basic Medical Sciences of Xinxiang Medical University,Xinxiang 453003,Henan Province,China;Department of Pathology,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,Henan Province,China)

机构地区：[1]新乡医学院第一附属医院肿瘤科,河南卫辉453100 [2]新乡医学院基础医学院病理教研室,河南新乡453003 [3]新乡医学院第一附属医院病理科,河南卫辉453100

出　　处：《新乡医学院学报》2021年第4期328-331,共4页Journal of Xinxiang Medical University

基　　金：河南省医学科技攻关项目(编号:2018020369);河南省高等学校重点科研项目计划(编号:20B310010)。

摘　　要：目的探讨安罗替尼联合伊立替康二线治疗晚期复发难治性小细胞肺癌(small cell lung cancer,SCLC)的疗效与安全性。方法选择2018年1月至2019年1月新乡医学院第一附属医院收治的20例晚期复发难治性SCLC患者为研究对象,均给予伊立替康65 mg·m-2静脉滴注,第1、7天;口服盐酸安罗替尼胶囊12 mg,每日1次,第1~14天,每21 d为1个治疗周期,持续治疗4~6个周期。每2个治疗周期评价1次患者临床疗效,记录最佳疗效评价。对患者进行为期2 a的随访,记录患者无进展生存期(PFS),观察患者不良反应。分别于治疗前、治疗2个周期后,采用酶联免疫吸附法检测患者血浆转化生长因子-β1(TNF-β1)、血管内皮生长因子(VEGF)、基质金属蛋白酶2(MMP2)水平。结果患者最佳疗效为部分缓解13例,疾病稳定7例;客观缓解率(ORR)为65.0%(13/20),疾病控制率为100.0%(20/20)。20例患者PFS为(4.7±2.3)个月,其中13例ORR患者的PFS为(5.7±2.9)个月,7例脑转移患者的PFS为(2.9±1.3)个月。20例患者中有12例在治疗失败或复发转移后接受了三线化学治疗。20例患者发生疲乏12例(60.0%)、厌食5例(25.0%)、高血压10例(50.0%)、手足综合征4例(20.0%)、腹泻2例(10.0%)、白细胞下降10例(50.0%)、血小板减少9例(45.0%)、尿蛋白2例(10.0%),无治疗相关性死亡发生。治疗2个周期后患者血浆TNF-β1、VEGF、MMP2水平均显著低于治疗前(P<0.05)。结论伊立替康联合安罗替尼二线治疗晚期复发难治性SCLC的近期疗效确切,且不良反应可耐受。Objective To evaluate the efficacy and safety of anlotinib combined with irinotecan in the second-line treatment of advanced relapsed and refractory small cell lung cancer(SCLC).Methods A total of 20 patients with advanced relapsed and refractory SCLC admitted to the First Affiliated Hospital of Xinxiang Medical University from January 2018 to January 2019 were selected as the study subjects,and they were given irinotecan 65 mg·m-2 intravenously on the 1 st and 7 th day,and anlotinib capsules 12 mg orally once a day in the 1 st-14 th day,21 days of treatment were regarded as one cycle,and the treatment was continued for 4-6 cycles.The clinical efficacy of patients was evaluated once two treatment cycles,and the best efficacy was recorded.The patients were followed up for 2 years,the progression-free survival(PFS)of the patients after treatment was recorded,the adverse reactions of the patients were observed.Enzyme linked immunosorbent assay was used to detect the levels of plasma transforming growth factor-β1(TNF-β1),vascular endothelial growth factor(VEGF),and matrix metalloproteinase-2(MMP2)before treatment and 2 cycles after treatment.Results The best curative effect included 13 cases in partial remission,7 cases in stable disease.The objective response rate(ORR)was 65.0%(13/20),the disease control rate was 100.0%(20/20).The PFS of the 20 patients was(4.7±2.3)months,the PFS of 13 patients with ORR was(5.7±2.9)months,the PFS of 7 patients with brain metastases was(2.9±1.3)months.A total of 12 patients in the 20 patients received third-line chemotherapy after treatment failure or recurrence and metastasis.Among the 20 patients,there were 12 cases(60.0%)of fatigue,5 cases(25.0%)of anorexia,10 cases(50.0%)of hypertension,4 cases(20.0%)of hand-foot syndrome,2 cases(10.0%)of diarrhea,10 cases(50.0%)of leukopenia in,9 cases(45.0%)of thrombocytopenia and 2 cases(10.0%)of urinary protein.and proteinuria[10.0%(2/20)].No treatment-related deaths occurred.The levels of plasma TNF-β1,VEGF and MMP2 in patients after

关 键 词：小细胞肺癌 伊立替康 安罗替尼 临床疗效 

分 类 号：R734.2[医药卫生—肿瘤]