阿帕替尼联合化疗对晚期化疗后进展胃癌的疗效及安全性分析

Therapeutic effects and safety of apatinib combined with chemotherapy in treatment of advanced gastric cancer

目的评价阿帕替尼联合化疗(紫杉醇+替吉奥或伊立替康+替吉奥)治疗晚期化疗后进展胃癌的疗效及安全性。方法60例晚期胃癌患者随机分试验组和对照组,每组30例。试验组接受阿帕替尼+紫杉醇+替吉奥胶囊或阿帕替尼+伊立替康+替吉奥胶囊联合治疗,对照组采用紫杉醇+替吉奥胶囊或伊立替康+替吉奥胶囊联合化疗。观察2组疗效、不良反应发生情况和肿瘤标记物[癌胚抗原(CEA)、糖类抗原199(CA199)]。结果试验组疾病控制率、客观缓解率均优于对照组(P<0.05)。2组消化道反应、骨髓抑制、神经毒性、肝功能损伤发生率比较,差异无统计学意义(P>0.05)。试验组高血压、乏力、蛋白尿发生率较对照组高,差异有统计学意义(P<0.05)。2组化疗前CEA、CA199水平比较,差异无统计学意义(P>0.05),化疗2周后试验组CEA、CA199水平均低于对照组,差异有统计学意义(P<0.05)。结论阿帕替尼联合化疗的疾病控制率、客观缓解率均优于单纯化疗。并且不良反应可控。阿帕替尼联合化疗(紫杉醇+替吉奥或伊立替康+替吉奥)治疗晚期化疗后进展胃癌胃癌疗效确切、安全。

Objective To investigate the therapeutic effects and safety of apatinib combined with chemotherapy(paclitaxel+tegafur or irinotecan+tegafur)in treatment of advanced gastric cancer after advanced chemotherapy.Methods A total of 60 patients with advanced gastric cancer were randomly divided into experimental group and control group,with 30 patients in each group.The patients in experimental group were treated by combination medication of apatinib+paclitaxel+tegafur or apatinib+irinotecan+tegafur,however,the patients in control group were treated by combination chemotherapy of paclitaxel+tegafur or irinotecan+tegafur.After treatment,the therapeutic effects,the incidence rate of adverse reactions,and the changes of liver and kidney function,urine routine,blood routine,electrolyte,CA-199,CEA were observed and compared between the two groups.Results The disease control rate and objective remission rate in experimental group were superior to those in control group(P<0.05).There were no significant differences in the incidence rates of digestive tract reaction,bone marrow depression,neurotoxicity,liver function injury between the two groups(P>0.05),but the incidence rates of hypertension,acratia,proteinuria in experimental group were significantly higher than those in control group(P<0.05).Before chemotherapy there were no significant differences in the levels of CEA and CA199 between the two groups(P>0.05),after 2-week chemotherapy,the levels of CEA and CA199 in experimental group were significantly lower than those in control group(P<0.05).Conclusion The disease control rate and objective remission rate of apatinib combination chemotherapy are superior to those by simple chemotherapy,and the adverse reactions are controllable.The apatinib combination chemotherapy(paclitaxel+tegafur or irinotecan+tegafur)in effective and safe in treating advanced gastric cancer after advanced chemotherapy.