阿帕替尼治疗肺癌性淋巴管炎的疗效分析

Efficacy of apatinib in the treatment of pulmonary lymphangitic carcinomatosis

目的:总结并分析我科39例肺癌性淋巴管炎的临床治疗特点,评估阿帕替尼对肺癌性淋巴管炎的治疗效果,为肺癌性淋巴管炎的治疗寻找有效的治疗方法。方法:回顾性分析我科2018年6月至2019年6月经治的39例肺癌性淋巴管炎患者,口服甲磺酸阿帕替尼片治疗,每日剂量为425 mg,连续口服6周,总结并分析其治疗效果,随访患者无进展生存期(PFS)和总生存期(OS),以治疗前后CT影像学表现为主要指标,辅以肿瘤标志物、血气分析、临床症状指标的变化、药物不良反应等分析。结果:39例肺癌性淋巴管炎患者疗效均可评价,其中部分缓解(PR)18例,占比46.2%,稳定(SD)9例,占比23.1%,进展(PD)12例,占比30.8%。有效率(RR)(CR+PR)为46.2%,疾病控制率(DCR)(CR+PR+SD)为69.2%。平均无进展生存期(PFS)为5.2个月,中位OS为10.2个月。部分患者治疗前后的CT影像学表现明显好转,肿瘤标志物及血气分析差异具有统计学意义(P<0.05),临床表现包括胸腔积液、呼吸困难等症状均不同程度的缓解,不良反应均可耐受。结论:肺癌性淋巴管炎是一种肺恶性肿瘤晚期的淋巴管扩散疾病,阿帕替尼不仅疗效良好,带来了明显的生存获益,而且不良反应的发生率低,患者耐受良好。与传统的肺癌性淋巴管炎经典治疗方案相比,阿帕替尼已经成为其主要的治疗方式。

Objective:To summarize and analyze 39 cases of pulmonary lymphangitic carcinomatosis of my department,and evaluate the therapeutic effect of apatinib on pulmonary lymphangitic carcinomatosis,for the effective treatment of pulmonary lymphangitic carcinomatosis.Methods:39 cases of pulmonary lymphangitic carcinomatosis treated by our department from June 2018 to June 2019 were retrospectively analyzed.All patients were treated with apatinib orally at a daily dose of 425 mg for 6 consecutive weeks.Its therapeutic effect was summarized and analyzed,and the progression-free survival(PFS)and overall survival(OS)were followed up.CT imaging findings before and after the treatment was the main index,supplemented by tumor markers,analysis of blood gas,the change of clinical symptom index,etc for the analysis of adverse drug reactions.Results:The efficacy of 39 patients with pulmonary lymphangitic carcinomatosis was evaluated.Classification of the therapeutic effect included 18 patients(46.2%)of partially relieved(PR),9 patients(23.1%)of stable disease(SD),12 patients(30.8%)of progressive disease(PD).Effective rate(RR)(CR+PR)was 46.2%.Disease control rate(DCR)(CR+PR+SD)was 69.2%.Progression free survival(PFS)was 5.2 months.Median OS was 10.2 months.The CT imaging features of part patients before and after treat-ment improved markedly,the differences of tumor markers and blood gas analysis were statistically significant(P<0.05).Pleural effusion,dyspnea and other clinical symptoms had different degrees of relief.All the adverse eventswere tolerable.Conclusion:Pulmonary lymphangitic carcinomatosis is a disease of lymphatic spread in the advancedlung cancer.Apatinib not only has good curative effect,but also brings obvious survival benefits,and the incidence ofadverse reactions is low and the patient is well tolerated.Apatinib has become the main treatment of PLC compared tothe traditional treatment.