阿帕替尼联合替吉奥二线治疗晚期胃癌的临床观察

Clinical study of Apatinib combined with Tegafur as second line treating advanced gastric cancer

目的探讨阿帕替尼联合替吉奥二线治疗晚期胃癌的临床效果和安全性。方法选取2015年12月~2017年2月在我院肿瘤内科住院治疗的28例晚期胃癌患者,随机分为观察组和对照组,各14例。观察组采用阿帕替尼联合替吉奥二线治疗,治疗方法为阿帕替尼500 mg口服,1次/d,替吉奥胶囊40~60 mg口服,2次/d,第1~14天后停药1周,21 d为1个周期,至少完成4个周期治疗。对照组仅给予替吉奥胶囊单药二线化疗,治疗方法为替吉奥胶囊40~60 mg口服,2次/d,第1~14天后停药1周,21 d为1个周期,至少完成4个周期治疗。比较两组患者的治疗效果、营养状况、生活质量和不良反应。结果观察组的总缓解率和疾病控制率分别为21.4%和92.9%,显著高于对照组的7.1%和71.4%(P<0.01)。治疗后,观察组的生活质量显著低于对照组(P<0.01),营养状况评分情况显著优于对照组(P<0.05)。观察组的胸闷、高血压、蛋白尿、食欲下降、恶心呕吐、周围神经毒性和血红蛋白减少不良反应的发生率显著高于对照组(P<0.01或P<0.05)。结论阿帕替尼联合替吉奥二线治疗晚期胃癌的临床效果较好,但其不良反应较多,且可能降低患者的营养状况和生活质量,其临床应用需综合考虑慎重选择。

Objective To evaluate the clinical effect and safety of Apatinib combined with Tegafur as second line treat- ing advanced gastric cancer.Methods 28 patients with advanced gastric cancer treated in the department of internal medicine-oncology of our hospital from December 2015 to February 2017 were selected and randomly divided into ob- servation group and control group,each group contains 14 patients.Observation group was treated with Apatinib of 500 mg,qd,and Tegafur Capsules of 40-60 mg for oral administration,bid,from day 1 to day 14 then withdrawal for one week,and 21 days were one cycles.The whole treatment lasted at least 4 cycles.Control group only received Tegafur Capsulesas second line treatment of 40-60 mg for oral administration,bid,from day 1 to day 14,then withdrawal for one week,and 21 days were one cycles.The whole treatment lasted at least 4 cycles.The treatment effect,the nutritional sta- tus,the quality of life,and the adverse reactions between the two groups were compared after treatment.Results The total remission rate and disease control rate of the observation group （21.4% and 92.9%） were significantly higher than those of the control group （7.1% and 71.4%） （P〈0.Ol）.The quality of life in the observation group was significantly lower than that in the control group after treatment （P〈0.01）.The nutritional status score in the observation group was significantly better than that in the control group after the treatment （P〈0.01）.The incidence of chest tightness,hypertension,protein- uria,appetite loss,nausea and vomiting,peripheral nerve toxicity and hemoglobin reduction in the observation group were significantly higher than those in the control group （P〈0.01 or P〈0.05）. Conclusion The effect and toxicity of Apatinib combined with Tegafur as second line treatment of patients with advanced gastric cancer is better,but it has more ad- verse reactions,and may reduce the patients＇ nutritional status and quality of life,thus its clinical application should be considered carefully.