安罗替尼治疗晚期肝癌的疗效及预后的影响因素

Efficacy and prognostic factors of anlotinib in the treatment of advanced liver cancer

目的:评价安罗替尼治疗晚期肝细胞癌(hepatocellular carcinoma,HCC)的疗效,并探讨预后的影响因素。方法:回顾性分析接受安罗替尼的70例晚期HCC患者,观察近期客观疗效和不良反应,分析各临床因素对近期疗效的影响。采用Kaplan-Meier进行生存分析,Cox回归模型进行单因素分析和多因素分析,评价各临床因素与生存期的关系。结果:70例患者中,完全缓解0例,部分缓解22例,疾病稳定28例,疾病进展20例,客观缓解率为31.43%,疾病控制率为71.43%。美国东部肿瘤协作组(Eastern Cooperative Oncology Group,ECOG)评分为0~1的患者疾病控制率显著高于ECOG评分为2的患者(P<0.05),而年龄、性别等其他临床因素对疾病控制率无明显影响(P>0.05)。患者随访2~15个月,中位总生存期为7.4个月(95%CI:6.9~8.7)。Cox回归分析显示ECOG评分(HR=1.402,P<0.001)、ALB水平(HR=1.572,P=0.011)是独立预测因素;ECOG评分为0~1的患者相比2分患者可以获得更长的中位总生存期(P=0.032),ALB>35 g/L的患者中位总生存期明显长于ALB≤35 g/L的患者(P=0.019)。安罗替尼常见不良反应主要为手足综合征(27/70,38.57%)、高血压(18/70,25.71%)、蛋白尿(15/70,21.43%)、血小板减少(13/70,18.57%)等,为1~2级,未见3级以上不良反应。结论:安罗替尼治疗晚期HCC有效且安全性良好,ECOG评分和ALB水平是患者预后的独立影响因素。

Objective:To evaluate the efficacy of anlotinib in the treatment of advanced hepatocellular carcinoma(HCC)and to explore the prognostic factors.Methods:A total of 70 patients with advanced HCC receiving anlotinib were retrospectively analyzed.The short-term objective efficacy and adverse reactions were observed,and the effects of clinical factors on the short-term efficacy were analyzed.Kaplan-Meier was used for survival analysis.Cox regression model was used for univariate analysis and multivariate analysis to evaluate the relationship between clinical factors and survival.Results:Among the 70 patients treated with anlotinib,there were 0 cases of complete remission,22 cases of partial remission,28 cases of stable disease,and 20 cases of disease progression.The objective remission rate was 31.43%, and the disease control rate was 71.43%. The disease control rate of patients with Eastern Cooperative Oncology Group (ECOG) score of 0-1 was significantly higher than that of patients with ECOG score of 2 (P<0.05), whereas other clinical factors such as age and gender had no significant effect on disease control rate (P>0.05). Patients were followed up for 2-15 months, and the median OS was 7.4 months (95%CI: 6.9 to 8.7). Cox regression analysis showed that the ECOG score (HR=1.402, P<0.001)and ALB level (HR=1.572, P=0.011) were independent predictors. Patients with ECOG score of 0-1 had longer median OS than patients with ECOG score of 2 (P=0.034). Patients with albumin (ALB) >35 g/L had longer median OS than patients with ALB ≤35 g/L (P=0.019). The common adverse reactions of anlotinib were hand-foot syndrome (38.57%), hypertension (25.71%), proteinuria (21.43%), and thrombocytopenia (18.57%), which were grade 1-2, and no adverse reactions above grade 3. Conclusion: Anlotinib is effective and safe in the treatment of advanced HCC. ECOG score and ALB level are independent prognostic factors.