阿帕替尼联合卡培他滨及替莫唑胺治疗转移性胃肠胰神经内分泌肿瘤的有效性及安全性研究  

Efficacy and safety of apatinib combined with capecitabine and temozolomide in treatment of metastatic gastroenteropancreatic neuroendocrine neoplasm

作　　者：李铁钢 崔志强 LI Tiegang;CUI Zhiqiang(Department of Oncology,980 Hospital of Chinese PLA Joint Logistics Support Forces,Shijiazhuang,Hebei 050082,China;First Department of Breast Surgery,Affiliated Hospital of Hebei Engineering University,Handan,Hebei 056000,China)

机构地区：[1]中国人民解放军联勤保障部队第九八〇医院肿瘤科,石家庄050082 [2]河北工程大学附属医院乳腺外一科,河北邯郸056000

出　　处：《重庆医学》2024年第17期2593-2597,共5页Chongqing Medical Journal

基　　金：河北省石家庄市科学技术研究与发展计划项目(201200643)。

摘　　要：目的探讨阿帕替尼联合卡培他滨及替莫唑胺治疗转移性胃肠胰神经内分泌肿瘤的有效性及安全性。方法选取2020年1月至2023年6月中国人民解放军联勤保障部队第九八〇医院收治的28例转移性胃肠胰神经内分泌肿瘤患者为研究对象,根据治疗方案的不同分为试验组(n=13)和对照组(n=15)。试验组给予阿帕替尼联合卡培他滨及替莫唑胺治疗,对照组给予卡培他滨及替莫唑胺治疗,直至疾病进展(PD)或不良反应不可耐受,主要观察指标为中位无进展生存(PFS)时间,次要终点包括客观缓解率(ORR)、疾病控制率(DCR)及不良反应情况。结果试验组完全缓解(CR)0例,部分缓解(PR)6例,疾病稳定(SD)4例,PD 3例,ORR为46.15%,DCR为76.92%,中位PFS时间为10.8个月。对照组CR 0例,PR 5例,SD 4例,PD 6例,ORR为33.33%,DCR为60.00%,中位PFS时间为9.2个月。试验组较对照组PFS时间延长1.6个月,PD或死亡风险下降58%(HR=0.42,95%CI:0.19~0.93,P=0.0094)。试验组发生化疗药物相关不良反应,同时也出现抗血管生成靶向药相关不良反应,但两组不良反应均为1~2级,予以治疗后可耐受。结论阿帕替尼联合卡培他滨及替莫唑胺治疗转移性胃肠胰神经内分泌肿瘤有效、安全。Objective To investigate the efficacy and safety of apatinib combined with capecitabine and temozolomide in the treatment of metastatic gastroenteropancreatic neuroendocrine neoplasm(GEP-NEN).Methods Twenty-eight patients with metastatic GEP-NEN admitted and and treated in this hospital from January 2020 to June 2023 were selected as the study subjects and divided into the experimental group(n=13)and control group(n=15)according to different treatment regimens.The experiment group was given apatinib combined with capecitabine and temozolomide.The control group was given capecitabine and temozolomide.The medication lasted until the disease progression(PD)or adverse reactions were intolerable.The main observation indicators were the median progression-free survival(PFS)time.The secondary endpoints included the objective response rate(ORR),disease control rate(DCR)and adverse reactions.Results The experimental group had 0 case of complete remission(CR),6 cases of partial remission(PR),4 cases of stable disease(SD)and 3 cases of PD.ORR and DCR were 46.15%and 76.92%respectively,and the median PFS was 10.8 months.The control group had 0 case of CR,5 cases of PR,4 cases of SD and 6 cases of PD.ORR and DCR were 33.33%and 60.00%respectively,and the median PFS was 9.2 months.PFS in the experiment group was prolonged by 1.6 months than the control group.PD or death risk was decreased by 58%(HR=0.42,95%CI:0.19-0.93,P=0.0094).The chemotherapeuti c drug related adverse reactions in the experimental group occurred,meanwhile the anti-angiogenesis targeting drug related adverse reactions also occurred,but the adverse reactions in the two groups all were grade 1-2,which were tolerated after treatment.Conclusion Apatinib combined with capecitabine and temozolomide is effective and safe in the treatment of metastatic GEP-NEN.

关 键 词：胃肠胰神经内分泌肿瘤 阿帕替尼 替莫唑胺 卡培他滨 酪氨酸激酶抑制剂 

分 类 号：R735.2[医药卫生—肿瘤]