阿帕替尼单药三线治疗二线化疗失败晚期结直肠癌临床观察

Apatinib in the Third-Line Treatment of Colorectal Cancer After Failure to Second-Line Chemotherapy

目的分析阿帕替尼单药三线治疗二线化疗失败的晚期结直肠癌患者的疗效和安全性。方法入组二线化疗失败的晚期结直肠癌患者38例,均给予阿帕替尼单药三线治疗,按治疗前血清甲胎蛋白(AFP)水平分为AFP阳性组(n=23)和AFP阴性组(n=15),比较观察2组近期疗效、生存情况和不良反应。结果38例患者阿帕替尼单药治疗有效率2.6%,疾病控制率60.5%,AFP阳性组和AFP阴性组有效率、疾病控制率比较差异均无统计学意义(P>0.05)。AFP阳性组和AFP阴性组中位疾病无进展生存时间比较差异无统计学意义(P>0.05)。APF阳性组中位生存时间显著低于AFP阴性组(P<0.05)。所有患者的不良反应均较轻,且2组不良反应发生率比较差异均无统计学意义(P>0.05)。结论阿帕替尼单药三线治疗晚期结直肠癌具有一定疗效,耐受性好,且AFP阴性患者可能是潜在获益患者。

Objective To observe the efficacy and safety of apatinib in the third-line treatment of colorectal cancer after failure to second-line chemotherapy.Methods A total of 38 patients with metastatic colorectal cancer after failure to second-line chemotherapy were selected and divided into the alpha fetoprotein(AFP) positive group(n=23)and the APF negative group(n=15), and all the patients were treatedwith apatinib. The short-term efficacy, survival and adverse events of the two groups were compared.Results The total effective rate of the 38 patientswas 2.6%, and the disease control rate was 60.5%. There was no statistical difference in the effective rate and disease control rate between the two groups(P>0.05). There was no statistical difference in the medianprogressionfreesurvival between the two groups(P>0.05). The median overall survival time in the AFP positive group was lowerthan that in the negative group(P<0.05). All the adverse events were tolerated. There was no statistical difference in the adverse event incidences between the two groups(P>0.05).Conclusion Apatinib is safe and effective in the third-line treatment of advanced colorectal cancer after failure to second-line chemotherapy, and the patients with AFP negative can get better curative.