阿帕替尼对二线及以上治疗失败晚期胃癌患者生活质量的影响

Effect of apatinib on quality of life of patients with advanced gastric cancer after failure of second-line or above therapy

目的:观察阿帕替尼对二线及以上治疗失败晚期胃癌患者生活质量的影响。方法:选取2017年01月-2020年01月本院收治的110例二线及以上治疗失败晚期胃癌患者为研究对象,采用随机数字法分为对照组(n=55)和观察组(n=55),对照组给予支持治疗,观察组给予阿帕替尼治疗,比较两组临床疗效、肿瘤标志物[癌胚抗原(CEA)、糖链抗原199(CA199)、糖链抗原125(CA125)]、生活质量(EORTC-QLQ-C30)评分、无进展生存期(PFS)、中位生存期(OS)及不良反应发生率。结果:治疗后观察组ORR为34.55%,DCR为63.64%,均高于对照组的14.55%和30.91%(P<0.05);治疗后观察组血清CEA、CA199、CA125水平低于对照组(P<0.05);治疗后观察组躯体功能、角色功能及情绪功能评分低于对照组(P<0.05);观察组PFS和OS长于对照组(P<0.05);观察组蛋白尿和高血压发生率高于对照组(P<0.05),两组恶心呕吐、腹泻、白细胞减少及手足综合征发生率比较差异无统计学意义(P>0.05)。结论:阿帕替尼对二线及以上治疗失败晚期胃癌患者疗效较好,可延伸患者生存期,提高生存质量,降低血清CEA、CA199、CA125水平,但对于血压控制不佳和合并肾功能障碍的晚期胃癌患者应慎重使用。

Objective:To observe effect of apatinib on quality of life of advanced gastric cancer patients with second-line or above treatment failure.Methods:A total of 110 patients with advanced gastric cancer and second-line or above treatment failure in the hospital were selected as the research subjects between January 2017 and January 2020.They were divided into control group(n=55)and observation group(n=55)by random number method.The control group was given supportive treatment,and the observation group was treated with apatinib.Clinical effects,tumor markers[carcinoembryonic antigen(CEA),carbohydrate antigen199(CA199),carbohydrate antigen125(CA125)],quality of life(EORTC-QLQ-C30)scores,progression-free survival(PFS),median survival(OS)and incidence of adverse reactions were compared between the two groups.Results:After treatment,the ORR and DCR of observation group(34.55%and 63.64%)were both higher than those of control group(14.55%and 30.91%)(P<0.05).Serum CEA,CA199 and CA125 levels in observation group were lower than those in control group(P<0.05).After treatment,the physical function,role function and emotional function scores of observation group were lower than those of control group(P<0.05).PFS and OS of observation group were longer than those of control group(P<0.05).Incidences of proteinuria and hypertension were higher in observation group than in control group(P<0.05),but there were no significant differences in incidences of nausea,vomiting,diarrhea,decreased white blood cells and hand-foot syndrome between the two groups(P>0.05).Conclusion:Apatinib is effective in treatment of advanced gastric cancer patients with second-line and above treatment failure.It can prolong the patients'survival,improve their quality of life,and reduce serum CEA,CA199 and CA125 levels.However,it should be used with caution for advanced gastric cancer patients with poor blood pressure control and renal dysfunction.