阿帕替尼在晚期肉瘤治疗中的疗效及安全性分析

The efficacy and safety analysis of apatinib in advanced sarcoma

目的:了解阿帕替尼在晚期肉瘤中的疗效及安全性,并分析影响其疗效的因素。方法:回顾分析口服阿帕替尼的晚期肉瘤患者临床资料,评价患者的无进展生存时间、总生存时间、客观缓解率、疾病控制率和不良反应发生率。结果:共收集30例口服阿帕替尼治疗的晚期肉瘤患者临床资料,中位随访时间为16.6个月(2.0~35.6个月),客观缓解率为23.3%,疾病控制率为86.7%。中位无进展生存时间为5.9个月(95%CI:4.7~7.1),中位总生存时间为19.2个月(95%CI:12.0~26.4)。年龄(χ^2=4.534,P=0.003)、转移灶个数(χ^2=14.803,P=0.001)、治疗线数(χ^2=8.539,P=0.003)是影响阿帕替尼治疗晚期肉瘤患者无进展生存时间的相关因素;转移灶个数(χ^2=4.991,P=0.025)是影响晚期肉瘤患者总生存时间的相关因素。30例患者均出现不同程度的不良反应,最常见的III^IV级严重的毒副反应为手足综合征(3.3%)、蛋白尿(6.7%)、白细胞下降(6.7%)和呕吐(3.3%),无因药物相关性毒副反应死亡的患者。结论:阿帕替尼治疗晚期肉瘤安全有效,越早使用,效果越好。

Objective:To evaluate the efficacy and safety of apatinib in advanced sarcoma,and to analyze the factors that affect the efficacy of apatinib.Methods:The clinical date of patients with advanced sarcoma who received apatinib was retrospectively analysed.Progression-free survival(PFS),overall survival(OS),objective responserate(ORR),disease control rate(DCR)and incidence of adverse reactions were evaluated.Results:A total of 30 patients were enrolled,the median follow-up time was 16.6 months(2.0-35.6 months),the objective remission rate(ORR)was 23.3%and the disease control rate(DCR)was 86.7%.The median progression-free survival time(mPFS)was 5.9 months(95%CI:4.7-7.1).The median total survival time(mOS)was 19.2 months(95%CI:12.0-26.4).Age(χ^2=4.534,P=0.003),the number of metastasis(χ^2=14.803,P=0.000)and treatment lines(χ^2=8.539,P=0.003)were related factor for affecting the PFS of apatinib with advanced sarcoma.The number of metastasis(χ^2=4.991,P=0.025)was related factor for affecting the OS of advanced sarcoma.30 patients had different level of drug-related adverse reactions in the course of treatment.The most common III-IV grade toxicity reactions were hand-foot-syndrome(3.3%),proteinuria(6.7%),leukopenia(6.7%),vomiting(3.3%)and there were no deaths due to drug-related adverse effect.Conclusion:Apatinib is effective and safe in the treatment of advanced sarcoma.The earlier it is used,the better the effect.