国际肿瘤学杂志

国际肿瘤学杂志 ›› 2019, Vol. 46 ›› Issue (4): 221-225.doi: 10.3760/cma.j.issn.1673-422X.2019.04.006

• 论著 • 上一篇    下一篇

阿帕替尼联合多西他赛治疗晚期血清甲胎蛋白阳性胃癌的临床观察

唐仕敏,刘黎,董华琼   

  1. 四川省遂宁市中心医院肿瘤中心  629000
  • 收稿日期:2018-10-30 修回日期:2019-01-01 出版日期:2019-04-08 发布日期:2019-05-29
  • 通讯作者: 刘黎，Email: cltsm032727@126.com E-mail:cltsm032727@126.com

Clinical observation of apatinib combined with docetaxel in treatment of advanced serum alpha-fetoprotein-positive  gastric cancer

Tang Shimin, Liu Li, Dong Huaqiong   

  1. Department of Oncology, Suining Central Hospital of Sichuan Province, Suining 629000, China
  • Received:2018-10-30 Revised:2019-01-01 Online:2019-04-08 Published:2019-05-29
  • Contact: Liu Li, Email: cltsm032727@126.com E-mail:cltsm032727@126.com

PDF

430

摘要： 目的  观察阿帕替尼联合多西他赛在晚期血清甲胎蛋白阳性胃癌(AFPGC)三线及以上治疗中的疗效及安全性。方法  搜集四川省遂宁市中心医院2015年2月至2018年4月收治的41例AFPGC患者进行回顾性分析。根据治疗方式不同进行分组，试验组15例患者接受阿帕替尼联合多西他赛治疗，对照组26例患者接受单纯化疗或最佳营养支持治疗。通过实体瘤疗效评价标准（RECIST）1.1版、无进展生存期（PFS）、总生存期（OS）及美国国立癌症研究所常见不良反应事件评价标准（NCI CTCAE）4.0版标准评价其近期疗效、远期疗效、不良反应。结果  治疗2周期后，两组均无患者达到完全缓解（CR），试验组4例部分缓解（PR），7例病情稳定（SD），4例疾病进展（PD），对照组2例PR，7例SD，17例PD，两组患者治疗客观有效率（ORR）分别为26.67%（4/15），7.69%（2/26），临床控制率（DCR）分别为73.33%（11/15），34.62%（9/26）。两组间ORR比较差异无统计学意义（χ2=1.433，P=0.231），DCR比较差异具有统计学意义（χ2=5.707，P=0.017）。试验组与对照组中位PFS均为3.0个月，两组间差异无统计学意义（χ2=4.425，P=0.350）。中位OS分别为6.0个月、4.0个月，两组间差异有统计学意义（χ2=5.727，P=0.017）。试验组和对照组的白细胞减少发生率分别为73.33%（11/15）、30.77%（8/26），高血压发生率分别为40.00%（6/15）、0（0/26），蛋白尿发生率分别为26.67%（4/15）、0（0/26），食欲减退发生率分别为80.00%（12/15）、38.46%（10/26），出血发生率分别为33.33%（5/15）、3.85%（1/26），试验组均显著高于对照组（χ2=6.930，P=0.008；χ2=9.191，P=0.002；χ2=4.953，P=0.026；χ2=6.600，P=0.010；χ2=4.471，P=0.034），差异均有统计学意义。两组患者治疗期间血小板减少、贫血、恶心呕吐、腹泻、乏力、手足综合征发生率差异均无统计学意义（均P＞0.05）。结论   阿帕替尼联合多西他赛三线及以上治疗晚期AFPGC患者，DCR较高，可延长生存时间，该方案不良反应较大，但基本可耐受。

关键词: 胃肿瘤, 甲胎蛋白类, 阿帕替尼, 多西他赛

Abstract: Objective  To observe the efficacy and safety of apatinib combined with docetaxel in the third line and above treatment of advanced serum alpha-fetoprotein-positive gastric cancer (AFPGC). Methods  A total of 41 patients with AFPGC from February 2015 to April 2018 in Suining Central Hospital of Sichuan Province were retrospectively analyzed. The patients were divided into experimental group and control group according to different treatment methods, 15 patients in the experimental group received with apatinib combined with docetaxel, and 26 patients in the control group received chemotherapy alone or optimal nutritional support. The short-term efficacy, long-term efficacy and adverse reactions were evaluated by Response Evaluation Criteria in Solid Tumours (RECIST) version 1.1, progression-free survival (PFS), overall survival (OS) and National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 4.0. Results  After 2 cycles of treatment, no complete remission (CR) was achieved in either group, 4 partial remission (PR), 7 stable disease (SD), 4 progressive disease (PD) in the experimental group, and 2 PR, 7 SD, 17 PD in the control group. The objective response rate (ORR) was 26.67% (4/15) and 7.69% (2/26) respectively in the experimental group and the control group, with no significant difference (χ2=1.433, P=0.231). The disease control rate (DCR) was 73.33% (11/15) and 34.62% (9/26) respectively in the two groups, with significant difference (χ2=5.707, P=0.017). The median PFS of the experimental group and the control group were both 3.0 months, and there was no significant difference between the two groups (χ2=4.425, P=0.350). The median OS were 6.0 months and 4.0 months respectively, and the difference was statistically significant (χ2=5.727, P=0.017). The occurrence rates of leukopenia of the experimental group and the control group were 73.33% (11/15) and 30.77% (8/26), the occurrence rates of hypertension were 40.00% (6/15) and 0 (0/26), the occurrence rates of proteinuria were 26.67% (4/15) and 0 (0/26), the occurrence rates of poor appetite were 80.00% (12/15) and 38.46% (10/26), and the occurrence rates of hemorrhage were 33.33% (5/15) and 3.85% (1/26). The occurrence rates of the above adverse reactions in the experimental group were significantly higher than those in the control group (χ2=6.930, P=0.008; χ2=9.191, P=0.002;  χ2=4.953, P=0.026; χ2=6.600, P=0.010; χ2=4.471, P=0.034), and the differences were statistically significant. There was no significant difference in the incidence of thrombocytopenia, anemia, nausea and vomiting, diarrhea, fatigue and hand-foot syndrome between the two groups (all P>0.05). Conclusion  The DCR of apatinib combined with docetaxel in the third-line and above treatment of advanced AFPGC patients is higher. This scheme can prolong survival period, and the adverse reactions are more serious, but they are basically tolerable.

Key words: Stomach neoplasms, alpha-Fetoproteins, Apatinib, Docetaxel