阿帕替尼联合顺铂治疗甲胎蛋白阳性老年晚期胃癌的临床研究  

Efficacy of Apatinib Combined with Cisplatin in the Treatment of AFP Positive Advanced Gastric Cancer in Older Patients

作　　者：张琳 吴曙华[1] 孙晗 田昌俊[1] 郑媛[1] 李林芳 叶振宇[1] 赵奎[1] 沈旭东[1] Zhang Lin;Wu Shuhua;Sun Han;Tian Changjun;Zheng Yuan;Li Linfang;Ye Zhenyu;Zhao Kui;Shen Xudong(The Second Affiliated Hospital of Suzhou University,Suzhou 215000)

机构地区：[1]苏州大学附属第二医院,苏州215000

出　　处：《国际老年医学杂志》2021年第3期129-132,共4页International Journal of Geriatrics

基　　金：江苏省自然科学基金青年基金(BK20160338);苏州市第九批产业技术创新专项(SYS201554)。

摘　　要：目的比较分析阿帕替尼联合顺铂治疗甲胎蛋白(AFP)阳性和阴性老年晚期胃癌患者的疗效及其影响因素。方法收集苏州大学附属第二医院2015年1月~2017年12月收治的老年晚期胃癌病例资料140例,以治疗前AFP水平分为阳性组和阴性组,比较两组接受阿帕替尼联合顺铂一线治疗的近远期临床疗效及影响因素。结果阳性组的疾病缓解率显著高于阴性组,差异有统计学意义(P<0.05);阳性组的中位总生存期优于阴性组,差异有统计学意义(P<0.05)。单因素分析结果显示:分化程度、病理类型、肝脏转移及肿瘤分期与预后相关(P<0.05);多因素分析结果显示:分化程度、病理类型、肝脏转移及肿瘤分期是阿帕替尼联合顺铂治疗预后的影响因素。阳性组骨髓抑制、胃肠道反应发生率与阴性组比较,差异均无统计学意义(P>0.05)。结论阿帕替尼联合顺铂一线治疗方案能使老年AFP阳性晚期胃癌受益更多,并且分化程度、病理类型、肝脏转移及肿瘤分期是预后的独立影响因素。Objective To explore the effect of apatinib combined with cisplatin on alpha fetal protein(AFP)positive advanced gastric cancer and influential factors.Methods 140 cases with advanced gastric cancer treated in the Second Affiliated Hospital of Suzhou University were enrolled between January 2015 and December 2017.The patients were divided into AFP positive group and AFP negative group according to AFP level before treatment.The short and long-term clinical efficacy and influential factors in the two groups were compared after treatment with apatinib and cisplatin.Results The response rate in APF positive group was significantly higher than that in AFP negative group(P<0.05).The median overall survival in APF positive group was significantly longer than that in AFP negative group(P<0.05).Univariate analysis showed that the tumor differentiation,pathological characteristics,liver metastasis and tumor stage were correlated with prognosis(P<0.05).Multivariate analysis showed that the tumor differentiation,pathological characteristics,liver metastasis and tumor stage were the influential factors for prognosis of patients treated with apatinib and cisplatin.There were no significant differences in the incidences of bone marrow suppression and gastrointestinal adverse reactions between the two groups(P>0.05).Conclusion The combination of apatinib and cisplatin might be effective in the treatment of AFP positive advanced gastric cancer in older patients.The tumor differentiation,pathological type,liver metastasis and tumor stage were the independent factors influencing the prognosis.

关 键 词：阿帕替尼 顺铂 甲胎蛋白阳性 晚期胃癌 

分 类 号：R735.2[医药卫生—肿瘤]