安罗替尼对骨肉瘤肺转移的疗效分析  

Analysis of the efficacy of anlotinib on lung metastasis of osteosarcoma

作　　者：张军良 王德辉 范晓雯 施鑫 周幸 周光新 ZHANG Jun-liang;WANG De-hui;FAN Xiao-wen;SHI Xin;ZHOU Xing;ZHOU Guang-xin(Department of Orthopedics,General Hospital of Eastern Theater Command,Nanjing,Jiangsu,210002,China)

机构地区：[1]中国人民解放军东部战区总医院骨科,南京210002 [2]南京中医药大学金陵临床医学院,江苏省210000

出　　处：《中国骨与关节杂志》2024年第5期336-341,共6页Chinese Journal of Bone and Joint

基　　金：国家自然科学基金青年项目(81802693);国家自然科学基金面上项目(82373153)。

摘　　要：目的分析安罗替尼在骨肉瘤肺转移患者的疗效。方法对2018年1月至2022年11月,我院收治的28例使用安罗替尼的骨肉瘤伴肺转移的患者进行回顾分析,中位年龄21(7~62)岁,男19例,女9例。患者肺部至少一个5 mm结节性病灶。所有患者3周为一个治疗周期(服药2周后停药1周),至少服药3个周期以上。除5例行安罗替尼单药治疗外,其余患者安罗替尼联合化疗、放疗、免疫治疗或手术治疗等。结果随访时间4~50个月,中位随访时间15个月。本组28例,死亡17例,存活11例,总生存率42.86%;23例(82.14%)肺部病灶有进展,5例肺部病灶无进展。所有病例中位无进展生存期(median progression-free survival,m-PFS)为7.17个月,中位总生存时间(median overall survival,m-OS)15.00个月。经分析发现,肺部病灶体积越大,合并肺外转移灶及既往使用过靶向药物的患者治疗效果越差,预后也越差,而是否联合治疗、肺部病灶出现时间、肺部病灶数量与疗效无明显相关。所有患者中,19例(67.86%)出现22例次不同程度的并发症,其中1/2级并发症占所有并发症的86.36%。结论安罗替尼对骨肉瘤肺转移患者有积极疗效,可以考虑在早期联合使用。单药使用疗效证据不足。并发症一般可耐受,可以安全使用。Objective To analyze the efficacy of anlotinib for patients with osteosarcoma lung metastasis.Methods A retrospective analysis was performed on 28 patients with osteosarcoma admitted to our hospital from January 2018 to November 2022.All had lung metastasis and were treated with anlotinib.The median age of patients was 21 years(range:7-62 years),including 19 males and 9 females.Patients had at least one 5 mm nodular lesion in the lungs.All patients took the drug for 3 weeks as a cycle(2 weeks of drug,1 week of discontinuation),and took the drug for at least 3 cycles or more.In addition to 5 patients with anlotinib alone,anlotinib was treated in combination with chemotherapy,radiotherapy,immunotherapy or surgery.Results Follow-up lasted 4-50 months.The median follow-up time was 15 months.There were 17 deaths and 11 survivors,and the overall survival rate was 42.86%.82.14%(23/28)of patients had progression of lung lesions,and only 5 cases had no progression of lung lesions.The median progression-free survival(m-PFS)of all cases was 7.17 months and the median overall survival(m-OS)was 15.00 months.After analysis,it was found the patients who had the larger the volume of lung lesions,or extrapulmonary metastases,or previous use of targeted drug had the worse treatment effect and the worse prognosis.Combination therapy,time of occurrence of lung lesions,and the number of lung lesions were not significantly correlated with the efficacy.Among all patients,19(67.86%)patients had 22 complications of varying degrees,of which grade 1/2 complications accounted for 86.36%of all complications.Conclusions Anlotinib has a positive effect on patients with osteosarcoma lung metastases,and early combination can be considered.There is insufficient evidence for efficacy with monotherapy.Complications are generally tolerated.

关 键 词：骨肉瘤 肿瘤转移 治疗结果 无进展生存期 安罗替尼 

分 类 号：R738.1[医药卫生—肿瘤]