阿帕替尼治疗晚期胃癌临床观察

发布时间：2018-10-18 12:37

【摘要】：目的目前仅仅有少数靶向药物可以改善晚期胃癌患者的预后,研究显示甲磺酸阿帕替尼作为三线方案可以改善胃癌患者生存质量。本研究对晚期胃癌使用甲磺酸阿帕替尼的临床疗效和安全性进行分析。方法回顾性分析2015-01-30-2016-10-01安徽省肿瘤治疗中心收治的30例化疗失败、有可测量病灶晚期胃癌患者临床资料,其中安徽省立医院肿瘤科16例,安徽省心脑血管医院肿瘤科9例和安徽省肿瘤医院肿瘤内科5例。所有患者予以甲磺酸阿帕替尼单药500mg,1次/d,口服28d为1个周期至疾病进展,观察临床疗效和不良反应。采用Cox比例风险回归模型进行生存分析。结果全部患者均可评价疗效。其中完全缓解占0(0/30),部分缓解占10.0%(3/30),疾病稳定占46.7%(14/30),疾病进展占43.3%(13/30)。缓解率为10.0%,疾病控制率为56.7%(17/30),中位无进展生存时间为3.84个月,中位生存时间为4.95个月,甲磺酸阿帕替尼主要不良反应包括高血压、蛋白尿、手足综合征和腹泻。Cox比例风险回归模型进行生存分析显示,随着治疗时机线数的增加(HR=5.029,95%CI为1.519~16.653,P=0.008)、体质量减少(HR=22.095,95%CI为3.624~134.700,P=0.001)疾病进展的风险增加。有手足综合征者死亡风险较低(HR=0.331,95%CI为0.153~0.714,P=0.005),而体质量减轻者的死亡风险较高(HR=6.549,95%CI为1.079~39.744,P=0.041)。结论甲磺酸阿帕替尼治疗化疗失败的晚期胃癌仍有较好的疾病控制及生存获益,不良反应可控制。出现手足综合征的患者早期使用可能具有生存优势。
[Abstract]:Objective only a few targeted drugs can improve the prognosis of patients with advanced gastric cancer. Studies have shown that Apatinib mesylate as a three-line regimen can improve the quality of life of gastric cancer patients. In this study, the clinical efficacy and safety of Apatinib mesylate in advanced gastric cancer were analyzed. Methods the clinical data of 30 patients with advanced gastric cancer who were admitted to Anhui Cancer treatment Center from January 30 to January 2016-January 2015-01-2016-January were retrospectively analyzed, including 16 cases in Department of Oncology, Anhui Provincial Hospital. 9 cases in Department of Oncology, Anhui Cardiovascular and Cerebrovascular Hospital and 5 cases in Department of Oncology, Anhui Cancer Hospital. All patients were given Apatinib mesylate 500 mg / d once a day for 28 days from one cycle to the progress of the disease. The clinical efficacy and adverse reactions were observed. Cox proportional risk regression model was used for survival analysis. Results all patients can evaluate the curative effect. Of these, complete remission was 0 (0 / 30), partial remission was 10.0% (3 / 30), disease stability was 46.7% (14 / 30), disease progression was 43.3% (13 / 30). The remission rate was 10.0%, the disease control rate was 56.7% (17 / 30), the median survival time was 3.84 months and the median survival time was 4.95 months. The main adverse effects of Apatinib mesylate included hypertension and proteinuria. Survival analysis using the Cox proportional risk regression model showed that the risk of disease progression increased with the increase of the number of therapeutic time lines (HR=5.029,95%CI = 1.519 卤16.653) and the decrease of body mass (HR=22.095,95%CI = 3.624 ~ 134.700 / P0. 001). The risk of death was lower in patients with hand and foot syndrome (HR=0.331,95%CI = 0.153) and higher in those with reduced body mass (HR=6.549,95%CI = 1.07939.744). Conclusion Apatinib mesylate still has good disease control and survival benefits and adverse reactions can be controlled. Early use may have a survival advantage in patients with hand-foot syndrome.
【作者单位】：安徽省立医院肿瘤科;安徽省肿瘤医院肿瘤内科;安徽省心脑血管医院肿瘤科;
【分类号】：R735.2

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