阿帕替尼对晚期肺鳞癌维持治疗的临床疗效研究  

Clinical Observations of the Effect of Apatinib in the Maintenance Treatment of Advanced Lung Squamous Cell Carcinoma

作　　者：邹俊韬[1] 胡珍珍[1] 杨慧明 熊林楷[1] 陈颖兰[1] ZOU Juntao;HU Zhenzhen;YANG Huiming(Jiangxi Cancer Hospital,Nanchang,330029)

机构地区：[1]江西省肿瘤医院,330029 [2]江西省樟树市人民医院,331299

出　　处：《实用癌症杂志》2021年第12期1989-1992,共4页The Practical Journal of Cancer

基　　金：江西省卫健委科技计划资助(编号:20181114)。

摘　　要：目的探讨阿帕替尼维持治疗一线化疗后晚期肺鳞癌的疗效及安全性。方法收集40例晚期非小细胞肺癌患者,一线治疗为4~6个周期的GP方案化疗,将疗效达稳定或缓解的患者随机分两组,一组给予最佳支持治疗(对照组),一组给予阿帕替尼治疗(观察组);比较两组PFS、血清VEGFR水平、KPS评分及评估安全性。结果观察组和对照组的中位PFS分别为7.6个月(95%CI:6.6~8.9)和4.3个月(95%CI:3.5~5.8)(P<0.05)。维持治疗开始前观察组和对照组患者血清中血管内皮生长因子(VEGF)和CYFRA21-1(细胞角质蛋白19片段)水平差异均无统计学意义(P>0.05),治疗后观察组患者血清中VEGF水平明显低于对照组(265.13±18.26 vs 326.35±19.38)pg/ml,(P<0.05),角质蛋白值变化不明显。阿帕替尼治疗后患者KPS评分仍基本维持在1分。患者不良反应较轻,主要为高血压、手足综合症及乏力(发生率为25%、25%及10%),经治疗后可缓解。结论阿帕替尼维持治疗一线化疗后稳定的晚期肺鳞癌患者,可提高PFS,维持较好的KPS评分,改善生活质量,安全性好。Objective To determine the safety and effectiveness of apatinib in maintenance therapy of advanced non-small cell lung cancer after effective first-line chemotherapy.Methods After 4~6 cycles of GP regimen treatment,40 patients with advanced lung squamous cell carcinoma in phase IV reached stable or partical response.The patients were randomly divided into 2 groups.Apatinib group was treated with apatinib,and the control group was treated with optimal supportive care.Progression-free survival(PFS),quality of life(Karnofsky score),levels of VEGF in serum and side effects were compared between the 2 groups.Results The median progression-free survival of the apatinib group and the control group was 7.6 months(95%CI:6.6~8.9)and 4.3 months(95%CI:3.5~5.8)(P<0.05),respectively.There was no difference in serum levels of VEGF between the 2 groups before treatment.After treatment,the serum level of VEGF in the study group had significant decrease from baseline[(265.13±18.26 vs 326.35±19.38)pg/ml](P<0.05),with greater reduction seen in apatinib group than that of the control group(P<0.05).KPS score in the apatinib group was still 1 point.The major toxicity and side effects were high blood pressure,hand-foot syndrome and weakness,the incidence rate was 25%,25%and 10%respectively.Conclusion The maintenance therapy of apatinib is safe and effective for advanced lung squamous cell carcinoma patients after chemotherapy.It can improve PFS,and maintain the quality of life.

关 键 词：阿帕替尼 肺肿瘤 鳞状细胞癌 抗血管生成药物 维持治疗 

分 类 号：R734.2[医药卫生—肿瘤]