低剂量阿帕替尼联合化疗二线治疗对晚期胃癌患者的疗效  

Efficacy of low-dose apatinib combined with second-line chemotherapy in patients with advanced gastric cancer

作　　者：王俊斌[1] 王栓虎[2] 张露[1] 吴骁 周海荣[1] 曾会会 WANG Jun-bin;WANG Shuan-hu;ZHANG Lu;WU Xiao;ZHOU Hai-rong;ZENG Hui-hui(Department of Oncology,the First Affiliated Hospital of Bengbu Medical College,Bengbu,Anhui 233004,China;不详)

机构地区：[1]蚌埠医学院第一附属医院肿瘤内科,安徽蚌埠233004 [2]蚌埠医学院第一附属医院胃肠外科,安徽蚌埠233004

出　　处：《中国临床研究》2022年第5期622-626,共5页Chinese Journal of Clinical Research

基　　金：安徽省高校自然科学研究重点项目(KJ2019A0295,KJ2020A0584)。

摘　　要：目的探讨低剂量阿帕替尼联合化疗二线治疗晚期胃癌患者的临床疗效、安全性、血清肿瘤标志物和血管内皮生长因子(VEGF)水平的变化。方法选取2019年1月至2020年12月于蚌埠医学院第一附属医院确诊的经过一线含铂方案化疗失败的晚期胃癌患者50例,依据二线治疗方案是否使用阿帕替尼分为两组,观察组25例采用低剂量阿帕替尼联合白蛋白结合型紫杉醇或多西他赛治疗,对照组25例单纯采用白蛋白结合型紫杉醇或多西他赛,21 d为1个治疗周期。观察两组患者临床疗效、不良反应、血清肿瘤标志物(CEA、CA19-9、CA724)及血管内皮生长因子(VEGF)水平。结果观察组和对照组患者的客观缓解率(ORR)分别为20.0%和12.0%,差异无统计学意义(P>0.05);疾病控制率(DCR)分别为76.0%和48.0%,中位无进展生存期(mPFS)分别为4.8(95%CI:4.2~5.5)个月和3.5(95%CI:3.3~4.4)个月,两组比较差异有统计学意义(P<0.05)。观察组高血压、手足综合征发生率高于对照组(P<0.05),其他不良反应比较差异无统计学意义(P>0.05)。治疗后两组患者血清中CEA、CA19-9、CA724和VEGF水平均降低(P<0.05),与对照组比较,观察组降低更加明显(P<0.05)。结论低剂量阿帕替尼联合二线化疗治疗晚期胃癌患者可提高临床疗效,安全耐受,可显著降低血清肿瘤标志物及VEGF水平。Objective To explore the clinical efficacy,safety,serum tumor markers and vascular endothelial growth factor(VEGF)levels of low-dose apatinib combined with second-line chemotherapy in patients with advanced gastric cancer.Methods A total of fifty patients with advanced gastric cancer who were diagnosed in the First Affiliated Hospital of Bengbu Medical College from January 2019 to December 2020 after first-line platinum-containing chemotherapy were selected.According to whether the second-line treatment plan used apatinib or not,they were divided into two groups.The observation group was treated with low-dose apatinib combined with albumin-bound paclitaxel or docetaxel,and the control group was treated with pure albumin-bound paclitaxel or docetaxel,21 days as a treatment cycle.The clinical efficacy,adverse reactions,tumor markers(CEA、CA19-9、CA724)and VEGF levels were observed between two groups.Results The objective response rate(ORR)of the observation group and the control group were 20.0%and 12.0%,respectively,which were not statistically significant(P>0.05).The disease control rate(DCR)was 76.0%and 48.0%,and the median progression-free survival(mPFS)was 4.8 months(95%CI:4.2-5.5)and 3.5 months(95%CI:3.3-4.4),respectively,and there were statistical differences between the two groups(P<0.05).The incidence of hypertension and hand-foot syndrome in the observation group was higher than that in the control group(P<0.05),but there was no significant difference in other adverse reactions(P>0.05).After treatment,the serum levels of CEA,CA19-9,CA724 and VEGF in two groups were decreased(P<0.05),and the decrease was more obvious in observation group compared with control group(P<0.05).Conclusions Low-dose apatinib combined with second-line chemotherapy in the treatment of patients with advanced gastric cancer can improve the clinical efficacy,safe tolerance,and significantly reduce serum tumor markers and VEGF levels.

关 键 词：阿帕替尼 晚期胃癌 二线化疗 肿瘤标志物 血管内皮生长因子 

分 类 号：R735.2[医药卫生—肿瘤]