贝伐珠单抗与阿帕替尼联合化疗方案对复发性脑胶质瘤治疗效果的比较研究  

Comparison of the Efficacy of Combined Chemotherapy with Bevacizumab and Apatinib in the Treatment of Recurrent Glioma

作　　者：丁铃 周静[1] 顾莹[1] 江棋[2] DING Ling;ZHOU Jing;GU Ying;JIANG Qi(Department of Pharmacy,Nantong Tumor Hospital,Nantong 226000,China;Department of Hematology and Lymphoma,Nantong Tumor Hospital,Nantong 226000,China)

机构地区：[1]江苏省南通市肿瘤医院药剂科,226000 [2]江苏省南通市肿瘤医院血液淋巴瘤科,226000

出　　处：《实用心脑肺血管病杂志》2025年第1期98-102,共5页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：江苏省自然科学基金面上项目(BK20201172)。

摘　　要：目的比较贝伐珠单抗与阿帕替尼联合化疗方案对复发性脑胶质瘤的治疗效果。方法选取2021年1月—2022年10月于南通市肿瘤医院就诊的复发性脑胶质瘤患者92例,采用随机数字表法将患者分为贝伐珠单抗组和阿帕替尼组,每组46例。贝伐珠单抗组患者给予替莫唑胺胶囊口服及贝伐珠单抗注射液静脉滴注;阿帕替尼组患者给予替莫唑胺胶囊及甲磺酸阿帕替尼片口服,4周为1个治疗周期,两组均治疗3个治疗周期。比较两组临床疗效,治疗前后血清学指标[血管内皮生长因子(VEGF)、表皮生长因子受体(EGFR)、胶质纤维酸性蛋白(GFAP)、甲壳质酶蛋白40(YKL-40)]和卡氏评分,生存率,治疗期间毒副作用发生率。结果阿帕替尼组客观缓解率高于贝伐珠单抗组(P<0.05)。两组疾病控制率比较,差异无统计学意义(P>0.05)。治疗后,阿帕替尼组VEGF、EGFR、GFAP、YKL-40低于贝伐珠单抗组(P<0.05)。治疗后,阿帕替尼组卡氏评分高于贝伐珠单抗组(P<0.05)。阿帕替尼组累积生存率高于贝伐珠单抗组(P<0.05)。阿帕替尼组高血压、蛋白尿发生率低于贝伐珠单抗组(P<0.05)。结论与贝伐珠单抗联合化疗方案比较,阿帕替尼联合化疗方案可提高复发性脑胶质瘤患者客观缓解率,降低细胞因子,提高生活质量、生存率并减少毒副作用的发生率。Objective To compare the efficacy of combined chemotherapy with bevacizumab and apatinib in the treatment of recurrent glioma.Methods From January 2021 to October 2022,a total of 92 patients with recurrent glioma treated at the Nantong Tumor Hospital were selected as the study subjects.Patients were divided into the bevacizumab group and the apatinib group using the random number table method,with 46 patients in each group.Patients in the bevacizumab group were given temozolomide capsules orally and bevacizumab injection intravenously,patients in the apatinib group were given temozolomide capsules and apatinib mesylate tablets orally,4 weeks was 1 treatment cycle,and both groups were treated for 3 treatment cycles.The clinical efficacy,serological indexes[vascular endothelial growth factor(VEGF),epidermal growth factor receptor(EGFR),glial fibrillary acidic protein(GFAP),and chitinase protein-40(YKL-40)]and Karnofsky score before and after treatment,survival rate,and the occurrence of toxicities during the treatment were compared between the two groups.Results The objective response rate of apatinib group was higher than that of bevacizumab group(P<0.05).There was no significant difference in disease control rate between the two groups(P>0.05).After treatment,VEGF,EGFR,GFAP,and YKL-40 of apatinib group were lower than those of bevacizumab group(P<0.05).The Karnofsky score of apatinib group was higher than that of bevacizumab group(P<0.05).Cumulative survival rate of apatinib group was higher than that of bevacizumab group(P<0.05).The incidence of hypertension and proteinuria in the apatinib group was lower than that in the bevacizumab group(P<0.05).Conclusion Compared with bevacizumab combination chemotherapy,apatinib combination chemotherapy can increase the objective remission rates of patients with recurrent gliomas,reduce cytokines,increase the quality of life and survival rate,and reduce the incidence of toxicities.

关 键 词：神经胶质瘤 贝伐珠单抗 阿帕替尼 治疗结果 

分 类 号：R730.264[医药卫生—肿瘤]