阿帕替尼联合紫杉醇二线治疗Her-2阴性晚期胃癌临床分析

Clinical analysis of apatinib with paclitaxel as the second-line chemotherapy of Her-2 negative advanced gastric cancer

目的:探讨阿帕替尼联合紫杉醇二线治疗Her-2阴性晚期胃癌的疗效与安全性。方法:回顾性分析2015年1月～2017年6月在我院诊治的Her-2阴性复发转移晚期胃癌经铂类联合氟尿嘧啶类一线化疗后病情进展30例患者,根据二线治疗给药方案不同分组,阿帕替尼联合紫杉醇治疗15例为观察组,单药紫杉醇化疗15例为对照组,分析两组临床疗效及不良反应。结果:观察组与对照组RR无统计学差异(20. 0%vs. 13. 3%,P>0. 05);观察组较对照组延长中位无进展生存时间(m PFS)(5. 1个月vs. 3. 6个月,P<0. 05);中位生存时间(m OS)比较差异无统计学意义(8. 3个月vs. 6. 4个月,P>0. 05)。不良反应以Ⅰ～Ⅱ度为主,Ⅲ～Ⅳ度少见,观察组乏力、高血压发生率较对照组高(P<0. 05),均经治疗后好转。结论:Her-2阴性晚期胃癌二线应用阿帕替尼联合紫杉醇方案疗效优于单药紫杉醇,不良反应易控,安全性高。

Objective: To observe the efficacy and safety of apatinib combined with paclitaxel as the sendond-line chemotherapy for Her-2 negative advanced gastric cancer. Methods: Retrospective analysis was performed in 30 cases of Her-2 negative advanced recurrent gastric cancer with metastatisis diagnosed and treated in our hospital from January 2015 to June 2017 after the first-line chemotherapy on platinum with fluorouracil basis.The cases were equally divided into observational group(apatinib+paclitaxel) and control group(simple paclitaxel) by the therapy protocol,and the two groups were analyzed regarding clinical efficacy and adverse reactions. Results: The two groups were not significantly different concerning the objective efficiency(RR)(20% vs. 13.3%, P > 0.05) and median survival time(mOS)(8.3 months vs. 6.4 months, P > 0.05),yet patients in the observational group had prolonged median progression free survival(mPFS)than those in the control group(5.1 months vs. 3.6 months, P< 0.05).Adverse reactions were primarily in Ⅰ-Ⅱ degree,and Ⅲ-Ⅳ degree was rare.Patients in the observational group had higher incidence of fatigue and hypertension than those in the control group ( P< 0.05),which were improved after treatment.Conclusion: Apatinib combined with paclitaxel may be superior to simple paclitaxel as the second-line chemotherapy for Her-2 negative advanced gastric cancer.Adverse reactions associated with the therapy can be easy to control and the safety is higher.