阿帕替尼治疗晚期胃癌40例临床观察

Clinical observation of apapatinib in the treatment of advanced gastric cancer： a report of 40 cases

目的评估阿帕替尼治疗晚期胃癌的疗效与不良反应。方法选取40例应用阿替帕尼治疗的晚期胃癌患者，阿替帕尼用量：750 mg口服，1次/d，每4周为一疗程。评估患者的疗效，采用Kaplan-Meier方法分析无病生存期（DFS）与影响患者DFS的因素，记录并评估不良反应发生情况。结果40例全部为腺癌，疾病总缓解率为5.0%（2/40），疾病控制率为42.5%（17/40）。甲胎蛋白（AFP）阳性患者疾病控制率（71.4%）高于AFP阴性患者（30.3%），差异有统计学意义（P＝0.025）。患者的DFS中位时间为3.87个月，采用Kaplan-Meier分析影响疗效的因素，结果表明美国东部协作组（ECOG）与AFP是患者DFS的影响因素（P＝0.039、0.041）。最常见的不良反应为白细胞减少、高血压、血小板减少症。结论阿替帕尼治疗晚期胃癌疗效高，耐受性好，可以提高晚期胃癌患者的疾病控制率，延长患者的生存时间，值得推广应用。

Objective To evaluate the efficacy and adverse reaction of apatinib in the treatment of advanced gastric cancer.MethodsForty patients with advanced gastric cancer were selected and treated with alteplain of 850 mg once a day for one course of treatment. The efficacy on patients was evaluated, Kaplan-Meier method was used to analyze the disease-free survival （DFS）, the influencing factors of DFS in patients and the adverse reactions were observed and evaluated.ResultsAll of the 40 patients were diagnosed with adenocarcinoma. The overall response rate was 5.0% （2/40） and the disease control rate was 42.5% （17/40）. The control rate of alpha-fetoprotein-positive （AFP-positive） patients was significantly higher than that of AFP-negative patients （62.5% vs. 37.5%, P=0.025）. The median value of DFS was 3.7 months. Kaplan-Meier analysis showed that ECOG and AFP were the influencing factors of DFS （P=0.039 and 0.041, respectively）. The most common adverse reactions were leukopenia, hypertension and thrombocytopenia.ConclusionsThe treatment of advanced gastric cancer can get high efficacy and good tolerance and can improve the disease control rate of patients with advanced gastric cancer and prolong the survival time of patients. It is worth popularizing and applying.