阿帕替尼治疗晚期胃癌的疗效及对血管内皮生长因子水平的影响

Effect of apatinib on gastric cancer and correlation with serum level of vascular endothelial growth factor

目的初步评价阿帕替尼对晚期胃癌三线治疗的临床疗效及对血清血管内皮生长因子(VEGF)水平的影响。方法2016年1月至2017年12月,对30例经过一、二线化疗效果失败的晚期胃癌患者给予甲磺酸阿帕替尼治疗,观察晚期胃癌患者的近远期疗效和毒性不良反应,检测治疗前后血清VEGF水平变化。结果患者口服阿帕替尼14.7(8~22)周,疗效评价完全缓解(CR)3例,部分缓解(PR)13例,疾病稳定(SD)9例和疾病进展(PD)5例,有效率为53.3%(16/30),疾病控制率为83.3%(25/30)。中位随访8.6(5~16)个月,患者中位无进展生存期(PFS)为5.2个月(95%CI:0~8.8个月),总生存率(OS)为9.4个月(95%CI:6.8~12.5个月)。阿帕替尼治疗后血清VEGF明显降低,阿帕替尼有效的患者治疗后VEGF下降明显(P<0.05)。结论阿帕替尼对一、二线治疗失败的晚期胃癌患者临床疗效确切,能够改善患者的生存质量。血清VEGF水平在一定程度上可以反映阿帕替尼治疗的疗效。

Objective To evaluate the clinical efficacy of apatinib in three-line treatment of advanced gastric cancer and the change in serum vascular endothelial growth factor(VEGF)levels.Methods From January 2016 to December 2017,thirty patients with advanced gastric cancer who failed in first-line or second-line chemotherapy were treated with apatinib.The short-term and long-term effects and toxic side effects of patients were observed,and the changes of serum VEGF level before and after treatment were detected.Results After 14.7(8-22)weeks of oral administration of apatinib,3 cases of complete remission(CR),13 cases of partial remission(PR),9 cases of disease stability(SD)and 5 cases of disease progression(PD),the effective rate was 53.3%(16/30),and the disease control rate was 83.3%(25/30).The median follow-up period was 8.6(5-16)months.The median progression free survival(PFS)was 5.2 months(95%CI:0-8.8 months),and the overall survival rate(OS)was 9.4 months(95%CI:6.8-12.5 months).VEGF in serum decreased significantly after treatment(P<0.05).The degree of decline was more obvious in the patients with curative effect.Conclusions Apatinib has a definite clinical effect on patients with advanced gastric cancer who failed to receive first-line and second-line treatment,and can improve the quality of life of patients.The level of serum VEGF may reflect the therapeutic effect of apatinib to some extent.