国际肿瘤学杂志

国际肿瘤学杂志 ›› 2021, Vol. 48 ›› Issue (8): 479-483.doi: 10.3760/cma.j.cn371439-20200527-00091

• 论著 • 上一篇    下一篇

安罗替尼联合伊立替康三线治疗转移性食管癌的临床研究

赵慧娟(), 丁美钱, 陈文婷   

  1. 安徽省六安市中医院肿瘤放疗科 237006
  • 收稿日期:2020-05-27 修回日期:2021-02-10 出版日期:2021-08-08 发布日期:2021-09-08
  • 通讯作者: 赵慧娟 E-mail:11090908@163.com

Clinical study of anlotinib combined with irinotecan in the third line treatment of metastatic esophageal cancer

Zhao Huijuan(), Ding Meiqian, Chen Wenting   

  1. Department of Radiotherapy Oncology, Lu'an Hospital of Traditional Chinese Medicine of Anhui Province, Lu'an 237006, China
  • Received:2020-05-27 Revised:2021-02-10 Online:2021-08-08 Published:2021-09-08
  • Contact: Zhao Huijuan E-mail:11090908@163.com

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摘要：

目的 探讨安罗替尼联合伊立替康三线治疗转移性食管癌的临床疗效及不良反应。方法 选取2018年10月至2019年10月安徽省六安市中医院收治的,既往接受标准同步放化疗后发生远处转移,给予二线化疗失败的转移性食管癌患者52例,采用随机数字表法分为试验组和对照组,每组各26例。对照组给予伊立替康单药静脉化疗;试验组给予口服安罗替尼联合伊立替康静脉化疗。治疗2周期后评价两组患者的临床疗效及不良反应发生情况。结果 治疗前,试验组和对照组Karnofsky功能状态(KPS)评分差异无统计学意义(76.15±7.52 vs. 74.62±8.59,t=-0.137,P=0.892);治疗后两组差异亦无统计学意义(70.77±6.28 vs. 72.69±8.74,t=-1.761,P=0.084);但试验组治疗后KPS评分较治疗前有所下降(t=3.035,P=0.006);对照组治疗前后KPS评分差异无统计学意义(t=1.000,P=0.327)。两组患者不良反应主要为1~2级,试验组1~2级骨髓抑制和腹泻发生率分别为61.5%(16/26)、46.2%(12/26),明显高于对照组的19.2%(5/26)、19.2%(5/26),差异均有统计学意义(χ2=9.665,P=0.002;χ2=4.282,P=0.039)。试验组疾病控制率为73.1%(19/26),明显高于对照组的46.2%(12/26),两组差异有统计学意义(χ2=3.914,P=0.048);试验组和对照组患者中位无进展生存期分别为52 d和45 d,差异具有统计学意义(χ2=4.692,P=0.032)。 结论 安罗替尼联合伊立替康三线治疗转移性食管癌疗效明显,但一定程度增加了1~2级骨髓抑制、腹泻不良反应发生率,且KPS评分较治疗前有所下降。

关键词: 食管肿瘤, 安罗替尼, 伊立替康

Abstract:

Objective To investigate the clinical efficacy and adverse reactions of anlotinib combined with irinotecan in the third line treatment of metastatic esophageal cancer.Methods From October 2018 to October 2019, 52 patients with metastatic esophageal cancer who had developed distant metastasis after receiving standard concurrent chemoradiotherapy and failed second-line chemotherapy were selected from Lu'an Hospital of Traditional Chinese Medicine of Anhui Province. The patients were divided into experimental group and control group by random number table method, with 26 cases in each group. The control group was given intravenous chemotherapy with irinotecan. The experimental group was treated with oral erlotinib combined with intravenous chemotherapy of irinotecan. The clinical efficacy and adverse reactions of the two groups were evaluated after 2 cycles of treatment.Results Before treatment, there was no significant difference in Karnofsky performance status (KPS) score between the experimental group and the control group (76.15±7.52 vs. 74.62±8.59, t=-0.137, P=0.892). After treatment, there was no significant difference between the two groups (70.77±6.28 vs. 72.69±8.74, t=-1.761, P=0.084). However, after treatment, the KPS score in the experimental group was lower than that before treatment (t=3.035, P=0.006). There was no statistical significance in the KPS scores of the control group before and after treatment (t=1.000, P=0.327). Adverse reactions in the two groups were mainly grade 1-2. The incidences of grade 1-2 myelosuppression and diarrhea in the experimental group were 61.5% (16/26) and 46.2% (12/26), which were significantly higher than those in the control group (19.2%, 5/26 and 19.2%, 5/26), with statistically significant differences (χ2=9.665, P=0.002; χ 2=4.282, P=0.039). The disease control rate of the experimental group was 73.1% (19/26), which was significantly higher than that of the control group (46.2%, 12/26), and there was a statistically significant difference between the two groups (χ 2=3.914, P=0.048). The median progression-free survival of the experimental group and the control group was 52 days and 45 days, respectively, and there was a statistically significant difference (χ 2=4.692, P=0.032). Conclusion Anlotinib combined with irinotecan in the third-line treatment of metastatic esophageal cancer has obvious efficacy, but to a certain extent, it increases the incidence of grade 1-2 myelosuppression and diarrhea, and the KPS score is lower compared with before treatment.

Key words: Esophageal neoplasms, Anlotinib, Irinotecan