阿帕替尼治疗晚期肺腺癌的有效性和安全性研究

Efficacy and safety of apatinib in advanced lung adenocarcinoma

目的:观察甲磺酸阿帕替尼治疗晚期肺腺癌的临床疗效及不良反应。方法:回顾性分析中国人民解放军总医院2017年1月至2018年7月收治的96例二线及以上服用阿帕替尼或单纯化疗治疗晚期肺腺癌患者的疗效及安全性。以化疗组(n=35)为对照组,阿帕替尼单用(n=32)或联合替吉奥(n=29)为观察组。结果:单纯化疗组中位无进展生存期(mPFS)为3.4个月,与化疗组相比,单用阿帕替尼组mPFS为3.17个月(P=0.830),阿帕替尼联合替吉奥组为4.8个月(P=0.015)。服用阿帕替尼后出现的不良反应主要有乏力、高血压、蛋白尿和手足综合征。大多数不良反应经积极治疗均可缓解,只有2例患者分别因严重肝损伤和严重的手足综合征停药。三组3-4级不良反应发生率分别为20.00%(7/35)、15.62%(5/32)和17.24%(5/29),P=0.893。结论:阿帕替尼可用于晚期肺腺癌的二线及以上治疗,不良反应可控制,阿帕替尼联合替吉奥方案在晚期肺腺癌患者显示出良好的临床疗效,使患者在二线或以上继续获益。

Objective: To observe the efficacy and safety of apatinib in advanced lung adenocarcinoma patients.Methods: A retrospective study of 96 patients diagnosed as lung adenocarcinoma at stage Ⅳ from January 2017 to July 2018 in Chinese PLA General Hospital were conducted. Patients in control group( n = 35) were treated with traditional chemotherapy and patients in two experimental groups were treated with apatinib alone( n = 32) and apatinib combined with S-1( n = 29),respectively. Clinical efficacy,progress free survival and adverse reactions were observed. Results: Compared with the median PFS in chemotherapy alone group,which was 3. 4 months,that of apatinib alone and that of apatinib combined with S-1 were 3. 17 months( P = 0. 830) and 4. 8 months( P = 0. 015),respectively. The main adverse reactions in experimental groups were weakness,hyper-tension,proteinuria and hand-foot syndrome. Most of these side effects were relieved after positive treatment and only 2 patients in apatinib alone group stopped taking apatinib because of the intolerance of severe liver damage and serious hand-foot syndrome respectively. The incidence of adverse reactions in grades 3-4 were 20. 00%( 7/35),15. 62%( 5/32) and 17. 24%( 5/29) in the three groups,respectively( P = 0. 893). Conclusion: Apatinib exhibits an effect on advanced lung adenocarcinoma patients with manageable adverse reaction.