安罗替尼在二线靶向治疗耐药的晚期肺腺癌中的应用

Application Effect of Arotinib-in Second-line Targeted Treatment of Vrug-resistant Advanced Lung Adenocarcinoma

目的:探讨安罗替尼在二线靶向治疗耐药的晚期肺腺癌患者中的应用效果。方法:选取晚期肺腺癌患者112例随机分成两组。对照组给予注射用培美曲塞二钠联合顺铂注射液化疗,观察组给予盐酸安罗替尼胶囊治疗,比较两组患者治疗后的临床疗效、随访期间的PFS、治疗前后KPS评分、血清CEA、VEGF水平以及治疗期间的不良反应。结果:治疗后,观察组DCR高于对照组,差异有统计学意义(P<0.05)。治疗后两组血清VEGF水平,均呈降低趋势,且观察组下降趋势尤为明显,差异有统计学意义(P<0.05);血清CEA均下降,但组间比较差异无统计学意义(P>0.05)。治疗期间观察组血小板计数减少、中性粒细胞减少的发生率低于对照组,但蛋白尿、手足综合征的发生率高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者的KPS评分,与治疗前相比较,均呈升高趋势,且观察组升高趋势尤为明显,随访期间,观察组患者的PFS长于对照组,差异有统计学意义(P<0.05)。结论:盐酸安罗替尼胶囊可以有效地降低二线靶向治疗耐药的晚期肺腺癌患者的血清CEA、VEGF水平,安全性高,同时可提高近期临床疗效及患者的生存质量,延长生存期,应用效果显著。

Objective:To investigate the effect of arotinib in second-line targeted treatment of drug-resistant patients with advanced lung adenocarcinoma.Methods:112 patients with advanced lung adenocarcinoma were randomly divided into two groups.The control group was treated with pemetrexed disodium for injection combined with cisplatin injection,and the observation group was treated with arotinib hydrochloride capsule.The clinical efficacy,PFS during follow-up,KPS score before and after treatment,serum CEA,VEGF levels and adverse reactions during treatment were compared between the two groups.Results:After the treatment,the DCR of the observation group was 60.71%,which was higher than 37.50%of the control group(P<0.05);After the treatment,the level of serum VEGF in the two groups was decreased compared with that before the treatment,especially in the observation group(P<0.05).There was significant diffenence letween the grounps.Serum CEA decreased,but there was no significant difference between the groups(P>0.05).During the treatment,the incidence of thrombocytopenia and neutropenia in the observation group was lower than that in the control group,but the incidence of proteinuria and hand foot syndrome in the observation group was higher than that in the control group(P<0.05).After the treatment,the KPS scores of the two groups showed an upward trend compared with those before the treatment,especially in the observation group,During the follow-up period,the PFS of the observation group was significantly longer than that of the control group(P<0.05).Conclusion:Arotinib hydrochloride capsule can effectively reduce the levels of serum CEA and VEGF in the patients with drug-resistant advanced lung adenocarcinoma treated by second-line targeted therapy,with high safety.At the same time,it can improve the short-term clinical efficacy and the quality of life of patients,prolong the survival time,with the significant application effect.