阿帕替尼治疗一线化疗失败后晚期胃癌的临床效果及预后分析

Efficacy and Prognosis of Apatinib in Treatment of Advanced Gastric Cancer after First-lineChemotherapy

目的:分析阿帕替尼治疗一线化疗失败后的晚期胃癌的临床效果及预后。方法:选取2016年1月—2017年12月就诊于本院的一线化疗后进展的晚期胃癌患者92例。随机均分为两组,对照组46例,口服替吉奥治疗;研究组46例,口服阿帕替尼治疗,均治疗2个疗程。评估两组临床疗效、不良反应及随访1年的生存率,观察并比较两组治疗前后的血清相关细胞因子水平及生存质量变化。结果:研究组有效率(RR)及疾病控制率(DCR)(56.52%、80.43%)均比对照组(34.78%、60.87%)高,治疗2个疗程后,研究组的QLQ STO-22量表评分比对照组低,差异有统计学意义(P<0.05);治疗2个疗程后,研究组的血清血管内皮生长因子(VEGF)、白细胞介素-2受体(sIL-2R)水平及白细胞介素-4(IL-4)、IL-10水平均比对照组低,肿瘤坏死因子-α(TNF-ɑ)、γ-干扰素(IFN-γ)水平比对照组高,差异有统计学意义(P<0.05);研究组不良反应发生率及生存率与对照组差异无统计学意义(P>0.05)。结论:阿帕替尼治疗一线化疗后进展的晚期胃癌疗效确切,可调节Th1、Th2类细胞因子水平,抑制VEGF释放,改善患者生存质量,减轻病情,一定程度上提升生存率,且不良反应轻微。

Objective To analyze the efficacy and prognosis of apatinib in treatment of advanced gastric cancer after first-line chemotherapy.Methods 92 patients with advanced gastric cancer after first-line chemotherapy in the hospital from January 2016 to December 2017 were selected,and they were divided into groups by randomized controlled method.Control group(46 cases)orally took tegafur;research group(46 cases)orally took apatinib,with 2 courses of treatment in the two groups.The clinical efficacy,adverse reactions,survival rate during 1-year follow-up in the two groups were evaluated.The changes of serum cell factors and survival quality before and after treatment were observed.Results The response rate(RR)and disease control rate(DCR)of research group(56.52%,80.43%)were higher than those of control group(34.78%,60.87%),while after 2 courses of treatment,the score of QLQ STO-22 in research group was lower than that in control group(P<0.05);After 2 courses of treatment,the levels of vascular endothelial growth factor(VEGF),soluble interleukin-2 receptor(sIL-2R),interleukin-4(IL-4),IL-10 in research group were lower than those in control group,while the levels of tumor necrosis factor-α(TNF-α)andγ-interferon(IFN-γ)in research group were higher than those in control group(P<0.05);There was no statistical difference in the incidence of adverse reactions and survival rate between the two groups(P>0.05).Conclusion Apatinib in treatment of advanced gastric cancer after first-line chemotherapy is effective,it can regulate the levels of Th1 and Th2 cell factors,inhibit the release of VEGF level,improve survival quality,decrease the severity of disease,increase the survival rate,and have sight toxic-side effect.