阿帕替尼联合TP化疗方案治疗晚期食管癌的临床疗效及安全性分析

Clinical efficacy and safety of apatinib combined with TP chemotherapy in treatment of advanced esophageal cancer

目的观察阿帕替尼联合TP(多西他赛联合顺铂)化疗方案治疗晚期食管癌的临床疗效及安全性分析。方法选取自2016年10月至2018年1月郑州大学第一附属医院收治的经一线及以上化疗失败后的晚期食管癌患者60例为研究对象,分为观察组和对照组各30例。观察组应用阿帕替尼联合TP化疗方案治疗,对照组应用TP化疗方案治疗,21天为1个治疗周期,每2周期评估两组患者临床疗效及不良反应。结果经4周期治疗后,观察组客观缓解率(ORR)、中位无进展生存期(mPFS)略高于对照组(33.3%vs 20%,P=0.243和5.2个月vs 4.5个月,P=0.332),差异无统计学意义;观察组疾病控制率(DCR)高于对照组(86.7%vs 60%,P=0.020),差异有统计学意义;观察组高血压、手足综合征、蛋白尿高于对照组(P<0.05),恶心呕吐、骨髓抑制与对照组比较差异无统计学意义(P>0.05),所有毒副反应以Ⅰ~Ⅱ级为主,给予对症处理后均可得到缓解,患者可耐受;治疗后观察组与对照组血清CEA、CYFRA21-1水平均低于治疗前,且观察组降低水平明显高于对照组,差异有统计学意义(P<0.05)。结论阿帕替尼联合TP化疗方案治疗晚期食管癌疾病控制率高,可降低血清CEA、CYERA21-1水平,且不良反应可耐受,安全可靠,值得临床选择。

Objective To observe the clinical efficacy and safety of apatinib combined with TP chemotherapy(docetaxel combined with cisplatin)in the treatment of advanced esophageal cancer.Methods A total of 60 patients with advanced esophageal cancer admitted to the first affiliated hospital of zhengzhou university from October 2016 to January 2018 after failure of first-line or above chemotherapy were selected as research objects,and 30 patients were divided into observation group and control group.The observation group was treated with apatinib combined with TP chemotherapy,while the control group was treated with TP chemotherapy.The clinical efficacy and adverse reactions of patients in the two groups were evaluated every 2 cycles.Results After 4 cycles of treatment,the objective remission rate(ORR)and median progression-free survival(mPFS)of the observation group were slightly higher than those of the control group(33.3%vs 20%,P=0.243 and 5.2 months vs 4.5 months,P=0.332),with no statistically significant differences.The disease control rate(DCR)of the observation group was higher than that of the control group(86.7% vs 60%,P=0.020),and the difference was statistically significant.Hypertension,hand-foot syndrome and proteinuria in the observation group were higher than those in the control group(P<0.05).There was no statistically significant difference in nausea,vomiting and bone marrow suppression between the observation group and the control group(P>0.05).After treatment,serum CEA and cyfra21-1 levels in the observation group and control group were lower than those before treatment,and the decreased levels in the observation group were significantly higher than those in the control group,with statistically significant differences(P<0.05).Conclusion Apatinib combined with TP chemotherapy in the treatment of advanced esophageal cancer has a high control rate,can reduce the serum CEA and cyera21-1 levels,and the adverse reactions can be tolerated,safe and reliable,worthy of clinical selection.