标准方案治疗失败的老年晚期结直肠癌患者阿帕替尼单药治疗的疗效及安全性探讨

Efficacy,safety and common adverse reactions of Apatinib monotherapy in elderly patients with advanced colorectal cancer failing standard regimens

目的探讨标准方案治疗失败的老年晚期结直肠癌(CRC)患者接受阿帕替尼单药治疗的疗效安全性及常见不良反应的疗效预测分析。方法本研究为回顾性分析,2015年1月到2019年12月纳入标准方案治疗失败的老年晚期结直肠癌患者106例。纳入研究的患者接受阿帕替尼治疗的起始剂量为500 mg或250 mg,治疗后评估患者的客观缓解率(ORR)和疾病控制率(DCR);无进展生存期(PFS)和总生存期(OS);并记录患者治疗过程中出现的不良反应。结果疗效评估采用患者接受阿帕替尼治疗过程中出现的最佳疗效,其中部分缓解(PR)9例,疾病稳定(SD)68例,疾病进展(PD)29例,ORR为&5%,DCR为72.6%;106例患者的中位PFS为3.6个月,中位OS为10.1个月;发生率较高的不良反应为高血压(63例,59.4%)和手足综合征(51例,48.1%)。出现高血压患者和未出现高血压患者的中位PFS分别为5.0个月和3.0个月(P=0.008)。出现HFS患者和未出现HFS患者的中位PFS分别为5.4个月和3.0个月(P=0.013).结论阿帕替尼单药治疗标准方案失败的老年CRC患者具有初步的疗效和较好的安全性,发生高血压和手足综合征的患者具有较好的预后。

Objective To investigate the efficacy,safety and common adverse reactions of Apatinib monotherapy in elderly patients with advanced colorectal cancer(CRC)who failed to respond to standard regimens.Methods This was a retrospective study.A total of 106 elderly patients with advanced CRC who had failed standard regimens from January 2015 to December 2019 were included.Patients enrolled in this study received Apatinib with an initial dosage of 500 mg or 250 mg.The objective response rate(ORR)and disease control rate(DCR)were assessed after treatment with apatinib.The progression-free survival(PFS)and overall survival(OS)were evaluated during the follow-up period.Additionally,adverse reactions during treatment with apatinib were recorded.Results The efficacy was assessed by using the best overall response during apatinib treatment.Of 106 patients,there were 9 patients with partial response(PR),68 patients with stable disease(SD)and 29 patients with progressive disease(PD).The ORR was 8.5%and the DCR was 72.6%.The median PFS was 3.6 months and the median OS was 10.1 months.Relatively common adverse reactions in these patients were hypertension(63 patients,59.4%)and hand-foot syndrome(HFS)(51 patients,48.1%)during apatinib treatment.The median PFS of patients with hypertension and of patients without hypertension were 5.0 months and 3.0 months,respectively(P=0.008).The median PFS of patients with and without HFS were 5.4 months and 3.0 months,respectively(P=0.013).Conclusions Preliminary evidence suggests that Apatinib monotherapy has good efficacy and safety in elderly patients with advanced CRC who have failed standard regimens,and patients with adverse reactions such as hypertension and HSF still have a good prognosis.