甲磺酸阿帕替尼治疗经标准治疗失败的晚期卵巢癌临床观察

Efficacy of apatinib mesylate treatment for advanced ovarian cancer after failure of the standard treatment

目的:观察甲磺酸阿帕替尼治疗经标准化治疗失败的晚期卵巢癌患者的临床疗效及毒副反应。方法:选取2018年5月至2019年3月于安徽省肿瘤医院经标准治疗失败的45例晚期卵巢癌患者,口服甲磺酸阿帕替尼片1次/d(起始剂量500mg/d),治疗期间按不良反应分级进行减量,出现严重不良反应时,立即停止相关治疗;当严重不良反应降至1级以下时,将剂量调至250mg并重新开始治疗。通过定期门诊行影像学检查和CA125测定判定治疗效果,记录毒副反应并评估安全性。结果:13例患者未达到连续服药56天要求,因此仅对32例患者开展近期疗效评价。32例患者中无完全缓解(CR),部分缓解(PR)8例(25.00%),疾病稳定(SD)23例(71.88%),疾病进展(PD)1例(3.12%),客观缓解率(ORR)为25.00%,疾病控制率(DCR)为96.88%;不良反应主要为高血压、手足综合征、口腔溃疡、乏力,发生率分别为31.11%(14/45)、22.22%(10/45)、15.56%(7/45)、13.33%(6/45)。结论:甲磺酸阿帕替尼对于经标准治疗失败的晚期卵巢癌患者可能是一种安全且有效的治疗选择,但仍需增加样本量验证其临床的应用价值。

Objective:To observe the effect and toxic side effect of apatinib mesylate treatment for advanced ovarian cancer after failure of the standard treatment.Method:45 patients with advanced ovarian cancer after failure of the standard treatment from May 2018 to March 2019 were selected.Patients took apatinib mesylate an orally at initial dosage of 500mg/d,decrease the dosage according to the grade of adverse events during treatment.When serious adverse events occurred,the relevant treatment was stopped immediately.While the serious adverse reactions fall below grade 1,the dose was reduced to 250mg and restarted treatment.To observe the efficacy by the imaging and carbohydrate antigen 125(CA125)tests,treatment-related toxic side effect were recorded to evaluate its safety.Results:13 of the enrolled patients did not meet the requirement of continuous medication for 56 days,only the remaining 32 patients were evaluated for short-term efficacy.Among the 32 patients,no case showed complete response(CR),8(25.00%)cases with partial response(PR),23(71.88%)cases reached stable disease(SD),and 1(3.12%)case was progressed(PD).The objective response rate was 25.00%,and the disease control rate was 96.88%.Major toxic side effect include hypertension(31.11%,14/45),hand-foot-skin syndrome(22.22%,10/45),oral ulcer(15.56%,7/45),poor appetite(13.33%,6/45).Conclusion:Apatinib mesylate is effective and tolerable for patients with advanced ovarian cancer who failed the standard treatment.However,it is still necessary to increase the sample size to verify its clinical application value.