化疗联合甲磺酸阿帕替尼治疗贲门癌肝转移的效果与安全性

Curative effects and safety of chemotherapy combined with apatinib mesylate in the treatment of hepatic metastases from gastric cardia cancer

目的 观察化疗联合甲磺酸阿帕替尼治疗贲门癌肝转移患者的效果与安全性.方法 选择2015年3月至2018年3月于安阳市肿瘤医院就诊的贲门癌肝转移患者66例,按随机数字表法分为对照组及观察组,每组33例.对照组给予常规化疗,观察组在对照组治疗基础上给予甲磺酸阿帕替尼,治疗9周并随访1年.统计两组患者疗效、1年生存率及Ⅲ、Ⅳ度化疗不良反应发生率,检测癌胚抗原(CEA)、血管内皮生长因子(VEGF)、基质金属蛋白酶(MMP-9)水平,采用癌症患者生存质量量表(QLQ-C30)评估生存质量.结果 观察组治疗有效率及疾病控制率为66.67%(22/33)、87.88%(29/33),高于对照组的42.42%(14/33)、60.61%(20/33),P<0.05;观察组治疗后CEA、VEGF、MMP-9水平为(14.35±1.44)ng/ml、(317.48±31.75)ng/L、(1082.53±108.25)ng/L,低于对照组的(18.49±1.85)ng/ml、(468.15±46.82)ng/L、(1378.59±137.86)ng/L,P<0.05;观察组治疗后QLQ-C30评分均高于对照组(P<0.05);观察组1年生存率为84.85%(28/33),高于对照组的57.58%(19/33),P<0.05;两组患者Ⅲ、Ⅳ度化疗不良反应发生率比较差异未见统计学意义(P>0.05).结论 化疗联合甲磺酸阿帕替尼治疗贲门癌肝转移可提升疗效并改善患者生存质量.

Objective To observe the curative effects and safety of chemotherapy combined with apatinib mesylate for patients with hepatic metastases from gastric cardia cancer.Methods Sixty-six patients with hepatic metastases who were treated in Anyang Cancer Hospital from March 2015 to March 2018 were enrolled in the study.They were divided into control group and observation group according to random number table method,with 33 cases in each group.The control group was given routine chemotherapy.The observation group was given apatinib mesylate based on the treatment of the control group.All patients were treated for 9 weeks and followed up for 1 year.The curative effects,1-year survival rate,and incidence of adverse reactions caused byⅢandⅣlevel chemotherapy in both groups were statistically analyzed.The levels of carcinoembryonic antigen(CEA),vascular endothelial growth factor(VEGF)and matrix metalloproteinase(MMP-9)of both groups were measured.Quality of Life Questionnaire-Core 30(QLQ-C30)was performed to assess quality of life of all patients.Results The response rate of treatment and disease control rate in observation group were 66.67%(22/33)and 87.88%(29/33),respectively,which were higher than the 42.42%(14/33)and 60.61%(20/33)in control group(P<0.05).After treatment,levels of CEA,VEGF and MMP-9 in observation group were(14.35±1.44)ng/ml,(317.48±31.75)ng/L and(1082.53±108.25)ng/L,which were lower than(18.49±1.85)ng/ml,(468.15±46.82)ng/L and(1378.59±137.86)ng/L in control group(P<0.05).After treatment,QLQ-C30 score in observation group was higher than that in control group(P<0.05).The 1-year survival rate of observation group was 84.85%(28/33),higher than 57.58%(19/33)of control group(P<0.05).There was no significant difference in incidence of adverse ractions caused byⅢandⅣlevel chemotherapy between the two groups(P>0.05).Conclusions Chemotherapy combined with apatinib mesylate in the treatment of patients with hepatic metastases form gastric cardia cancer can improve curative effect and patient’s quality of life.