安罗替尼联合多西他赛二线治疗晚期非小细胞肺癌疗效观察

Efficacy of anlotinib combined with docetaxel chemotherapy as second-line treatment on advanced non-small cell lung cancer

目的观察晚期非小细胞肺癌患者应用安罗替尼联合多西他赛二线治疗后血清癌胚抗原(carcino-embryonic antigen,CEA)、血管内皮细胞生长因子(vascular endothelial growth factor,VEGF)水平变化,探讨其治疗效果及安全性。方法60例晚期非小细胞肺癌患者依据治疗方法分为观察组和对照组各30例。对照组给予多西他赛75 mg/m2,静脉滴注,第1天,21 d为1个周期;观察组在对照组化疗基础上口服安罗替尼胶囊12 mg/次,1次/d,第1~14天,21 d为1个周期。每2个周期评估1次疗效,至出现严重不良反应或疾病进展停药。比较2组化疗前及化疗4个周期后血清CEA、VEGF水平;化疗4个周期后评定2组疾病控制率、客观有效率;随访观察无进展生存时间;比较2组治疗期间不良反应发生情况。结果观察组、对照组化疗4个周期后血清CEA[(7.25±4.93)、(12.28±5.63)μg/L]和VEGF[(56.12±33.69)、(102.17±44.94)ng/L]水平均低于治疗前[CEA:(50.47±13.49)、(54.15±12.93)μg/L;VEGF:(407.41±147.32)、(411.44±143.56)ng/L](P<0.05),观察组低于对照组(P<0.05)。化疗4个周期,观察组疾病控制率(86.67%)高于对照组(60.00%)(P<0.05),客观有效率(26.67%)与对照组(20.00%)比较差异无统计学意义(P>0.05)。随访至2020年4月30日,观察组中位无进展生存时间(4.8个月)长于对照组(2.8个月)(P<0.05)。治疗期间2组不良反应多为Ⅰ~Ⅱ级,均可耐受,观察组手足综合征、高血压、咯血的发生率(36.67%、33.33%、13.33%)高于对照组(0、6.67%、0)(P<0.05)。结论晚期非小细胞肺癌患者应用安罗替尼联合多西他赛二线治疗可下调肿瘤标志物水平,提高疾病控制率,延长无进展生存时间,不良反应可耐受。

Objective To observe the changes of carcino-embryonic antigen(CEA)and serum vascular endothelial growth factor(VEGF)after the second-line treatment with anlotinib combined with docetaxel in patients with advanced non-small cell lung cancer,and to investigate the therapeutic effect and safety.Methods Sixty patients with advanced non-small cell lung cancer were equally divided into observation group and control group according to different treatment plan.Control group was given intravenous drip of docetaxel 75 mg/m~2 by day 1,totally for 21 days as one cycle,besides which observation group was given orally administration of anlotinib capsule 12 mg once a day by day 1 to 14,totally for 21 days as one cycle.The therapeutic effect was evaluated every two cycles.The treatment was terminated when the adverse reactions were intolerable or the disease was progressive.The levels of CEA and VEGF were detected in two groups before and after four-cycle chemotherapy.The disease control rate and objective effective rate were compared between two groups after four cycles.The progression-free survival time and the occurrence of adverse reactions were followed up and compared between two groups.Results The levels of CEA and VEGF were lower in observation group((7.25±4.93)μg/L,(56.12±33.69)ng/L)and control group((12.28±5.63)μg/L,(102.17±44.94)ng/L)after four-cycle chemotherapy than those before chemotherapy(observation group:(50.47±13.49)μg/L,(407.41±147.32)ng/L;control group:(54.15±12.93)μg/L,(411.44±143.56)ng/L)(P<0.05),and lower in observation group than those in control group(P<0.05).After four-cycle chemotherapy,the disease control rate was higher in observation group(86.67%)than that in control group(60.00%)(P<0.05),and the objective effective rate showed no significant difference between observation group(26.67%)and control group(20.00%)(P>0.05).Till April 30,2020,the median progression-free survival time was longer in observation group(4.8 months)than that in control group(2.8 months)(P<0.05).Most of the adverse reactions in two groups were gradeⅠtoⅡ,which were tolerable.The incidences of hand-foot syndrome,hypertension and haemoptysis were higher in observation group(36.67%,33.33%,13.33%)than those in control group(0,6.67%,0)(P<0.05).Conclusion The second-line treatment with anlotinib plus docetaxel in patients with advanced non-small cell lung cancer can lower the levels of tumor markers,improve the disease control rate,and prolong the progression-free survival time,and the adverse reactions are tolerable.