放疗联合阿帕替尼、多西他赛治疗晚期肺癌的临床疗效研究

Clinical Efficacy Study of Radiotherapy Combined with Apatinib and Docetaxel in the Treatment of Advanced Lung Cancer

目的探讨放疗联合阿帕替尼(VEGF靶点抑制剂)和多西他赛治疗晚期肺癌的疗效及安全性。方法晚期肺腺癌患者69例,随机分为治疗组(n=37)和对照组(n=32)。对照组进行放疗和阿帕替尼治疗,治疗组进行放疗联合阿帕替尼加多西他赛治疗。阿帕替尼(500 mg·d^-1,第1~21天,21天为1个周期)治疗;多西他赛(60 mg·m^-2,静脉滴注,第1天),治疗两个周期。所有患者用药直至疾病进展或不良反应不可耐受。分析比较两组的总缓解率(ORR)、疾病控制率(DCR)、不良反应发生率。结果中位随访时间10.8个月,治疗组和对照组的ORR分别为为48.65%和25.00%(P=0.0432),DCR分别为81.08%和56.25%(P=0.0254),两组相比有统计学差异。在骨髓抑制和消化道反应方面,两组差异不大,无统计学意义(P>0.05);与对照组相比,治疗组在皮疹脱发不良反应方面要重些,有统计学意义(P<0.05),但可以耐受。结论放疗联合阿帕替尼(VEGF靶点抑制剂)和多西他赛能进一步提高晚期肺癌的疾病控制和客观缓解率,不良反应可以耐受。

Objective To investigate the efficacy and safety of radiotherapy combined with apatinib(VEGF target inhibitor)and docetaxel in the treatment of advanced lung cancer.Methods 69 patients with advanced lung adenocarcinoma were randomly divided into the treatment group(n=37)and the control group(n=32).The control group received radiotherapy and apatinib.The treatment group received radiotherapy combined with apatinib plus docetaxel.Apatinib(500 mg·d^-1,day 1 to day 21,21 d for one cycle)treatment;docetaxel(60 mg·m^-2),intravenous drip,day 1),treatment for 2 cycles.All patients were administered until the disease progressed or the adverse reactions were intolerable.Analyze and compare the total response rate(ORR)、disease control rate(DCR)and incidence of adverse reactions between the 2 groups.Results The median follow-up time was 10.8 months.The ORR of the treatment group and the control group were 48.65%and 25%(P=0.0432),respectively,and the DCR was 81.08%and 56.25%(P=0.0254),respectively.There was a statistical difference between the 2 groups.In terms of myelosuppression and digestive tract reaction,there was no significant difference between the 2 groups(P>0.05):compared with the control group,the treatment group was heavier in the adverse reactions of rash and hair loss,Statistically significant(P<0.05),but tolerable.Conclusion Radiotherapy combined with apapitatin(VEGF target inhibitor)and docetaxel can further improve the disease control rate and the objective response rate of advanced lung cancer,and the adverse reactions can be tolerated.