化疗失败的老年晚期转移性结直肠癌患者呋喹替尼治疗效果及安全性

Efficacy and safety of fruquintinib in treatment of elderly patients with advanced metastatic colorectal cancer who failed chemotherapy

目的探讨呋喹替尼对化疗失败的老年晚期转移性结直肠癌患者的临床疗效及安全性。方法选择2018年9月至2020年7月联勤保障部队第904医院收治的99例化疗失败的老年晚期转移性结直肠癌患者。所有患者均口服呋喹替尼胶囊,1次/d,5 mg/次,连续用药21 d,停药7 d,28 d为1个周期,所有患者均持续治疗2个周期后观察效果。统计患者近期抗肿瘤疗效,比较治疗前后患者血清糖类抗原125(CA125)、癌胚抗原(CEA)、糖类抗原199(CA199)水平,记录患者治疗期间药物安全性,并采用Kaplan-Meier法进行生存分析。结果99例化疗失败的老年晚期转移性结直肠癌患者治疗2个周期,客观缓解率(ORR)为22.22%(22/99)、临床控制率(CCR)为75.76%(75/99);治疗后患者血清CA125、CA199、CEA水平均低于治疗前(均P<0.05);99例患者治疗期间发生的药物不良反应大多为Ⅰ~Ⅱ级,Ⅲ~Ⅳ级不良反应较少,最常见的Ⅰ~Ⅱ级不良反应为高血压(45.45%,45/99)、手足综合征(40.40%,40/99)、天冬氨酸氨基转移酶升高(36.36%,36/99);随访12个月,失访5例,随访率为94.95%,其余94例患者中位无进展生存时间为5.62个月(95%CI 3.57~8.75个月),中位总生存时间为8.41个月(95%CI 4.85~11.14个月)。结论呋喹替尼治疗化疗失败的老年晚期转移性结直肠癌患者疗效较好,可降低肿瘤标志物水平,患者生存状况良好,且不良反应可控。

Objective To investigate the clinical efficacy and safety of fruquintinib in elderly patients with advanced metastatic colorectal cancer who failed chemotherapy.Methods Ninety-nine elderly patients with advanced metastatic colorectal cancer who failed chemotherapy in No.904 Hospital of Joint Logistics Support Force from September 2018 to July 2020 were selected.All patients were given furquintinib capsules,1 time/d,5 mg/time,and 28 days was 1 cycle.All patients were treated continuously for 2 cycles and the effect was observed.The patient's recent anti-tumor efficacy was counted.The serum levels of carbohydrate antigen 125(CA125),carcinoembryonic antigen(CEA)and carbohydrate antigen 199(CA199)in patients before and after treatment were compared.The safety of the medication during the patient's treatment was recorded,and the Kaplan-Meier method was used for survival analysis.Results A total of 99 elderly patients with advanced metastatic colorectal cancer who failed chemotherapy were treated for 2 cycles,with an objective response rate(ORR)of 22.22%(22/99)and a clinical control rate(CCR)of 75.76%(75/99).The serum levels of CA125,CA199 and CEA after treatment were lower than those before treatment(all P<0.05).The drug adverse reactions in 99 patients during the treatment were mostly gradeⅠ-Ⅱ,and gradeⅢ-Ⅳwere rare.The most common gradeⅠ-Ⅱadverse reactions were hypertension(45.45%,45/99),hand-foot syndrome(40.40%,40/99),and elevated aspartate transferase(36.36%,36/99).Followed up for 12 months,5 cases were lost to follow-up,the follow-up rate was 94.95%,the median progression-free survival time of the remaining 94 patients was 5.62 months(95%CI 3.57-8.75 months),and the median overall survival time was 8.41 months(95%CI 4.85-11.14 months).Conclusions Fruquintinib has good efficacy in the treatment of elderly patients with advanced metastatic colorectal cancer who failed chemotherapy.It can reduce the levels of tumor markers,the survival status of patients is good,and the adverse reactions are controllable.