阿帕替尼联合多西他赛二线化疗治疗晚期非鳞非小细胞肺癌的疗效观察

Curative Effect of Second-line Chemotherapy of Apatinib Combined with Docetaxel on Advanced Non-squamous Non-small-cell Lung Cancer

目的观察阿帕替尼联合多西他赛二线化疗治疗晚期非鳞非小细胞肺癌的疗效。方法选取2014年3月—2015年9月重庆市开州区人民医院收治的晚期非鳞非小细胞肺癌患者120例,均经一线含铂双药化疗方案治疗失败,采用随机数字表法分为A组、B组、C组,每组40例。A组患者单用阿帕替尼治疗,B组患者单用多西他赛治疗,C组患者采用阿帕替尼联合多西他赛治疗。比较3组患者近期疗效,无进展生存期(PFS),3～4级毒副作用发生率,化疗前及2个化疗周期后血管内皮生长因子(VEGF)、基质金属蛋白酶9(MMP-9)、癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)。结果 3组患者客观反应率(ORR)比较,差异无统计学意义(P>0.05);C组患者疾病控制率(DCR)高于A组、B组(P<0.017),而A组与B组患者DCR比较,差异无统计学意义(P>0.017)。C组患者中位PFS长于A组、B组(P<0.05),而A组与B组患者中位PFS比较,差异无统计学意义(P>0.05)。3组患者3～4级毒副作用发生率比较,差异无统计学意义(P>0.05)。化疗前3组患者VEGF、MMP-9、CEA、CYFRA21-1比较,差异无统计学意义(P>0.05);2个化疗周期后C组患者VEGF、MMP-9、CEA、CYFRA21-1低于A组、B组(P<0.05),而A组与B组VEGF、MMP-9、CEA、CYFRA21-1比较,差异无统计学意义(P>0.05)。结论阿帕替尼联合多西他赛二线化疗治疗晚期非鳞非小细胞肺癌的近期疗效可,可有效延长患者PFS,抑制肿瘤进展,且安全性较高。

Objective To observe the curative effect of second-line chemotherapy of apatinib combined with docetaxel on advanced non-squamous non-small-cell lung cancer.Methods From March 2014 to September 2015,a total of 120 patients with advanced non-squamous non-small-cell lung cancer were selected in the People's Hospital of Kaizhou District,Chongqing,and they were divided into A group,B group and C group according to random number table,each of 40 cases.Patients in A group received apatinib only,patients in B group received docetaxel only,while patients in C group received apatinib combined with docetaxel.Short-term curative effect,PFS,incidence of 3-to 4-grade toxic and side effects,VEGF,MMP-9,CEA and CYFRA21-1 before chemotherapy and 2 cycles after chemotherapy were compared between the two groups.Results No statistically significant differences of ORR was found in the three groups(P>0.05);DCR in C group was statistically significantly higher than that in A group and B group,respectively(P<0.017),while no statistically significant differences of DCR was found between A group and B group(P>0.017).Median PFS in C group was statistically significantly longer than that in A group and B group,respectively(P<0.05),while no statistically significant differences of median PFS was found between A group and B group(P>0.05).No statistically significant differences of incidence of 3-to 4-grade toxic and side effects was found in the three groups(P>0.05).No statistically significant differences of VEGF,MMP-9,CEA or CYFRA21-1 was found in the three groups before chemotherapy(P>0.05);VEGF,MMP-9,CEA and CYFRA21-1 in C group were statistically significantly lower than those in A group and B group 2 cycles after chemotherapy(P>0.05),while no statistically significant differences of VEGF,MMP-9,CEA or CYFRA21-1 was found between A group and B group(P>0.05).Conclusion Second-line chemotherapy of apatinib combined with docetaxel has relatively good short-term curative effect in treating advanced non-squamous non-small-cell lung cancer,can effectively lengthen the median PFS,inhibit the tumour progression,with relatively high safety.