安罗替尼联合EP方案一线治疗广泛期小细胞肺癌的回顾性研究  

Anlotinib combined with EP regimen as first-line treatment for extensive-stage small cell lung cancer:A retrospective study

作　　者：龚耀[1] 鞠立荣 张铁成[2] Gong Yao;Ju Lirong;Zhang Tiecheng(Department of Oncology,Seventh Division Hospital of Xinjiang Production and Construction Corps,Kuitun 833200,China;Department of Medical Oncology,Affiliated First Hospital of Huai'an,Nanjing Medical University,Huai'an 223300,China)

机构地区：[1]新疆生产建设兵团第七师医院肿瘤科,新疆维吾尔自治区奎屯833200 [2]南京医科大学附属淮安第一医院肿瘤内科,江苏淮安223300

出　　处：《实用肿瘤杂志》2022年第6期555-560,共6页Journal of Practical Oncology

摘　　要：目的观察安罗替尼联合化疗一线治疗广泛期小细胞肺癌(small cell lung cancer,SCLC)的疗效及安全性。方法选取2018年9月至2020年3月新疆生产建设兵团第七师医院(37例)及南京医科大学附属淮安第一医院(19例)收治的广泛期SCLC一线治疗患者56例,EP方案(依托泊苷100 mg/m2,d1~3;顺铂25 mg/m2,d1~3)联合安罗替尼治疗组(12 mg,d1~14;治疗组)26例与EP方案治疗组(对照组)30例。比较两组患者的生存情况和不良反应。对治疗组无进展生存期(progression-free survival,PFS)相关的临床因素进行单因素分析。结果治疗组和对照组客观有效率(objective response rate,ORR)和疾病控制率(disease control rate,DCR)比较,差异均无统计学意义(均P>0.05)。治疗组的中位PFS和中位总生存期(overall survival,OS)分别为6.0个月和14.2个月,均优于对照组的4.0个月和10.9个月,差异均具有统计学意义(均P<0.05)。治疗组中无肝转移的患者PFS优于有肝转移患者(P<0.05)。两组在血液学毒性方面相当。治疗组在高血压、手足综合征、口腔黏膜炎和甲状腺功能减退的不良反应发生率上高于对照组(均P<0.05)。治疗组3~4级不良反应经过对症处理及降低安罗替尼剂量后控制良好。未出现药物相关的死亡。结论安罗替尼联合化疗一线治疗广泛期SCLC可延长患者的OS和PFS,且不良反应多为Ⅰ~Ⅱ级,耐受性良好。Objective To analyze the efficacy and safety of anlotinib combined with chemotherapy in the first-line treatment of exten-sive-stage small cell lung cancer(SCLC).Methods Fifty-six extensive-stage SCLC patients treated in the Seventh Division Hospital of Xinjiang Production and Construction Corps(n=37)and Affiliated First Hospital of Huai'an,Nanjing Medical University(n=19)from Sep-tember 2018 to March 2020 were retrospectively reviewed.The patients were divided into the treatment group(n=26)and the control group(n=30).The treatment group were administrated with EP regimen(etoposide 100 mg/m2,d1-3;cisplatin 25 mg/m2,d1-3)combined with anlotinib(12 mg,d1-14).The control group were administrated with EP regimen.The survival and adverse events of the two groups were compared.Univariate analysis of clinical factors related to progression-free survival(PFS)was performed.Results There were no signif-icant differences in objective response rate(ORR)and disease control rate(DCR)between the two groups(both P>0.05).The median PFS and overall survival time(OS)of the treatment group were 6.0 and 14.2 months,respectively,which were significantly better than those of the control group(4.0 and 10.9 months,P<0.05).Patients without liver metastasis in the treatment group had better PFS than patients with liver metastasis(P<0.05).The two groups were comparable in terms of hematological toxicity.The incidence rates of adverse reactions of hypertension,hand-foot syndrome,oral mucositis,and hypothyroidism in the treatment group were higher than those in the control group(all P<0.05).Grade 3-4 adverse reactions in the treatment group were well controlled after symptomatic treatment and lowering the dosage of anlotinib.No drug-related mortality occurred.Conclusions Anlotinib combined with first-line chemotherapy has a good effect in treating extensive-stage SCLC,which can prolong the OS and PFS of the patients.Moreover,the majority of adverse events are grade 1-2,which can be well tolerated.

关 键 词：小细胞肺癌 安罗替尼 EP方案 一线治疗 生存 

分 类 号：R734.2[医药卫生—肿瘤]