阿帕替尼联合多西他赛治疗一线化疗失败的晚期小细胞肺癌的临床疗效  

Clinical effect of apatinib combined with docetaxel in treatment of advanced small cell lung carcinoma

作　　者：张海利 王志武[1] 董桂兰[1] 刘丽丽[1] 谷雪 吕立丽[1] ZHANG Haili;WANG Zhiwu;DONG Guilan;LIU Lili;GU Xue;LYU Lili(Department of Radiotherapy and Chemotherapy,Tangshan People’s Hospital,Tangshan 063000,China)

机构地区：[1]河北省唐山市人民医院放化疗科,唐山063000

出　　处：《中国临床药学杂志》2021年第3期161-165,共5页Chinese Journal of Clinical Pharmacy

基　　金：河北省2020年度医学科学研究课题(编号20201523)。

摘　　要：目的探究阿帕替尼联合多西他赛化疗治疗一线化疗失败的晚期小细胞肺癌的临床疗效及安全性。方法收集2017年7月至2018年4月收治的一线化疗失败的晚期小细胞肺癌患者86例,根据随机数字表法分为对照组和观察组,各43例。对照组采用多西他赛标准化疗方案治疗,观察组在对照组化疗方案的基础上予阿帕替尼治疗。比较2组患者的临床疗效、不良反应发生情况,血清癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)、胃泌素释放肽前体(ProGRP)水平,以及治疗结束后12、18、24个月的生存情况。结果治疗后,对照组和观察组的疾病控制率分别为76.7%和86.0%(P <0.05),客观缓解率分别为39.5%和55.8%(P <0.05)。2组治疗过程中的主要不良反应为手足综合征、高血压、血小板减少和白细胞减少,均为1~2级,其中手足综合征和高血压发生率以观察组为高(P <0.01),血小板减少及白细胞减少发生率以对照组为高(P <0.05)。观察组和对照组患者中位无进展生存期(mPFS)分别为117 d和160 d (P=0.001)。治疗后,2组患者CEA、NSE及ProGRP水平均较治疗前降低(P<0.05),且观察组低于对照组(P<0.05)。结论阿帕替尼联合多西他赛化疗对晚期小细胞肺癌患者显示出良好的疗效和安全性,且能够降低患者的CEA、NSE及ProGRP水平。AIM To explore the clinical efficacy of apatinib combined with docetaxel in treatment of advanced small cell lung carcinoma(SCLC)patients with failure of first-line chemotherapy.METHODS A total of 86 patients with advanced SCLC admitted from July 2017 to April 2018 were randomly divided into observation group and control group,with 43 patients in each group.The patients in control group were treated with docetaxel standard chemotherapy,while the patients in observation group were treated with apatinib and docetaxel standard chemotherapy.The clinical efficacy,adverse drug reactions(ADRs),the levels of carcinoembryonic antigen(CEA),neuron specific enolase(NSE)and progastrin-releasing peptide(ProGRP)in serum,and the survival at 12,18 and 24 months after the treatment were compared between 2 groups.RESULTS After treatment,the disease control rates of the control group and the observation group were 76.7%and 86.0%respectively(P<0.05),and the objective response rates of the control group and the observation group were 39.5%and 55.8%respectively(P<0.05).The main ADRs in 2 groups were hand foot syndrome,hypertension,thrombocytopenia and leukopenia,all of which were grade 1-2.The incidence of thrombocytopenia and leukopenia in the control group were higher than those in the treatment group(P<0.05);the incidence of hand foot syndrome and hypertension in the treatment group was higher than that in the control group(P<0.01).The median progression free survival(mPFS)of the observation group and the control group was 117 d and 160 d(P=0.001).The analysis of serum markers showed that CEA,NSE and ProGRP levels of the 2 groups were decreased(P<0.05).Compared with the control group,the CEA,NSE and ProGRP levels in the treatment group were significantly lower(P<0.05).CONCLUSION Apatinib combined with docetaxel shows good efficacy and safety in patients with advanced SCLC,and can reduce the levels of CEA,NSE and ProGRP.

关 键 词：阿帕替尼 多西他赛 小细胞肺癌 疗效 

分 类 号：R734.2[医药卫生—肿瘤]