阿帕替尼联合替吉奥治疗晚期一线化疗失败胃癌患者的临床效果

Clinical effects observation of apatinib combined with S1 in gastric cancer patients with advanced first-line chemotherapy failure

目的探讨阿帕替尼联合替吉奥在晚期一线化疗失败患者的临床疗效。方法选取2016年2月至2018年12月衡阳巿中心医院收治的76例一线化疗失败的胃癌患者,随机分为试验组和对照组,每组38例。试验组采取阿帕替尼联合替吉奥方案化疗,对照组采取FOLFIRI方案化疗,比较两组患者的临床疗效、药物不良反应及营养状况。结果试验组的近期疗效高于对照组(65.8%vs.44.7%,P<0.05),但两组的疾病控制率差异无统计学意义(89.5%vs.78.9%,P>0.05);试验组患者的无病生存期(PFS)为7.6~8.7个月,高于对照组的6.2~8.7个月,差异有统计学意义(P<0.05);试验组患者的总生存期(OS)为8.1~9.1个月,高于对照组的6.8~8.1个月,差异有统计学意义(P<0.05);试验组出现白细胞减少、腹泻、口腔黏膜炎的几率明显低于对照组,但I级蛋白尿发生率高于对照组,差异均有统计学意义(P<0.05);两组患者经治疗后营养风险均得到缓解,但试验组对于改善患者营养状况更具优势。结论与FOLFIRI方案对比,阿帕替尼联合替吉奥在晚期一线化疗方案失败患者中临床疗效更优,能有效提高患者的PFS和OS,减轻药物不良反应,改善患者营养状况,但尚不能改善患者的疾病控制率。

Objective To investigate the clinical observation of apatinib combined with S1 in gastric cancer patients with advanced first-line failure.Methods From February 2016 to December 2018,76 gastric cancer patients from Hengyang City Central Hospital who failed in first-line chemotherapy were selected,they were divided into observe group and control group randomly.The observe group was treated with apatinib combined S1,while control group was treated with FOLFIRI.The clinical efficacy,adverse drug reactions,and nutritional status of the two groups of patients were compared.Results compared with control group,the efficacy of apatinib combine S1 in the treatment of advanced gastric cancer patient with first-line chemotherapy failure was 65.8%vs.44.7%(P<0.05).But the disease control rate show no significant difference(89.5%vs.78.9%,P>0.05).PFS time was 7.6-8.7 months in observe group while 6.2-8.7 months in control group;OS time was 8.1-9.1 months in observe group while 6.8-8.1 months in control group.There were significant difference between the two group(P<0.05).Incidents of leukopenia,diarrhea and oral mucositis in the observe group was significant lower than that in control group(P<0.05).However,the incidents of grade I proteinuria in observe group was higher than control group(P<0.05).Both groups can alleviate the nutritional risk after treatment,but the observe group has more advantage in improving the nutritional status.Conclusions Compared with FOLFIRI regimen,apatinib combine with S1 has better clinical efficicacy in patient with advanced gastric cancer with first-line failure.It can effectively improve patient PFS and OS time.Also,that can reduce adverse drug reaction,improve patient nutritional status.However,It can't improve patient disease control rate.