阿帕替尼联合安替可治疗耐药型进展期胃癌12例临床研究

12 cases clinical observation of Apatinib combined with Antike in the treatment of antibioresistance type advanced gastric cancer

[目的]为了探讨阿帕替尼联合安替可治疗耐药型进展期胃癌的有效性及安全性。[方法]将入选病例根据患者家庭经济状况及个人意愿分为2组,治疗组采用阿帕替尼联合安替可方案,阿帕替尼初治剂量500mg/次,1次/d,1周期后患者能耐受剂量增至750mg/次,1次/d。安替可胶囊2粒/次,3次/d。对照组采用单药安替可治疗,用药方法同治疗组。3周为1周期,4周期后评价近期疗效,4周期后2组仍继续口服安替可胶囊,随访并观察中位PFS及中位OS。治疗组如评价有效继续口服阿帕替尼,如评价无效停服阿帕替尼。治疗前及治疗4周期后抽血查MMP-2、MMP-9。[结果]治疗组疾病控制率DCR66.7%,对照组疾病控制率DCR21.4%,2组差异有统学意义,P<0.05。治疗组中位PFS 3.1个月,对照组中位PFS 1.4个月,2组比较P<0.01;治疗组中位OS 6.4个月,对照组中位OS 4.1个月,2组比较P<0.01。治疗前2组MMP-2、MMP-9差异无统计学意义,治疗后MMP-2、MMP-9均有不同程度的下降,治疗组较对照组下降更明显,差异有统计学意义,P<0.01。治疗组毒副反应表现为Ⅰ-Ⅱ级的高血压、蛋白尿、肝功损害和手足综合症患者能耐受。[结论]阿帕替尼联合安替可是治疗耐药型进展期胃癌的有效低毒方案,值得推广应用。

[Objective]To explore the effect and safety of Apatinib combined with Antike in the treatment of antibioresistance type advanced gastric cancer.[Methods]Selected cases were randomly divided into two groups according to the patient＇s family economic conditions and personal wishes.The treatment group adopted Apatinib（500mg/time,1 time/day,after one cycle,the tolerated dose of patients was added to 750mg/time,1time/day）combined with Antike（2 pills/time,3 times/day）.The control group adopted simply Antike,other medication methods were the same as the treatment group.Three weeks as a period,the recent curative effect was evaluated and two groups still continued to take orally Antike capsules after 4cycles,follow-up visit was conducted and the median PFS and OS were observed.Whether continue to taking orally Apatinib was according to effective in the treatment group.Blood was drawn to checked MMP-2 and MMP-9 before radiotherapy and four cycles later.[Results]For effective rate,the treatment group DCR was 66.7%,while the control group DCR was 21.4%,There were statistically significant difference between two Groups,P0.05;For the median PFS,the treatment group was 3.1 months,while the control group was 1.4 months,P0.01;For the median OS,the treatment group was 6.4 months,while the controlgroup was 4.1 months,P0.01.There were no statistically significant difference between MMP-2 and MMP-9 of the two groups before the treatment.After the treatment,both of MMP-2 and MMP-9 of two Groups decreased in varying degrees,the treatment group decreased more obviously than the control group,there were statistically significant difference,P0.01.The adverse reaction in the treatment group wasⅠ-Ⅱlevel high blood pressure,proteinuria,liver damage and the brotherhood of syndrome was able to tolerate.[Conclusion]Apatinib combined with Antike is a effective and low toxicity method in the treatment of antibioresistance type advanced gastric cancer,and is worthy of popularization and application.