肝动脉化疗栓塞术联合阿帕替尼治疗不可切除胃癌肝转移的临床疗效及对血清VEGF表达的影响

Clinical Efficacy of Transcatheter Arterial Chemoembolizatio Combined with Apatinib for the Treatment of Non-reseractable Gastric Cancer Liver Metastasis and Influence of Serum VEGF Expression

目的:探讨肝动脉化疗栓塞术(TACE)联合阿帕替尼治疗不可切除胃癌肝转移的临床疗效及其对血清血管内皮生长因子(VEGF)表达的影响。方法:对2020年7月-2021年12月就诊于上海市静安区市北医院肿瘤科不可切除的胃癌肝转移化疗后进展为二线治疗的120例患者进行前瞻性研究。其中,对照组患者60例,采用阿帕替尼抗血管生成靶向治疗;观察组患者60例,采用TACE联合阿帕替尼治疗,两组均持续治疗3个月。比较两组患者血清VEGF浓度及临床疗效。结果:治疗3个月后,观察组患者血清VEGF浓度为(126.08±12.35) pg/ml,对照组患者为(181.52±11.7) pg/ml,差异有统计学意义(t=25.212,P<0.05)。观察组患者的总体治疗效果优于对照组,差异有统计学意义(χ~2=6.314,P<0.05)。治疗后,观察组患者客观缓解率和疾病控制率分别为43.4%和73.4%,对照组患者分别为25.0%、55.0%,差异均有统计学意义(χ~2值分别为4.483和4.385,P值均<0.05)。治疗后,观察组患者无进展生存期为(14.36±1.87)月,对照组患者为(10.25±1.45)月,差异有统计学意义(t=13.454,P<0.05)。结论:TACE联合阿帕替尼对不可切除的胃癌肝转移患者的治疗较阿帕替尼单独使用具有更好的临床疗效,且有利于延长患者的生存周期。

OBJECTIVE To explore the clinical efficacy of hepatic arterial chemoembolization(TACE)combined with apatinib in treating unre sec table gastric cancer liver metastasis and its effect on the expression of serum vascular endothelial growth factor(VEGF).METHODS A prospective study was conducted on 120 patients who went to the Oncology Department of Shibei Hospital of Jingan District in Shanghai from July 2020 to December 2021.Among them,60 patients in the control group were treated with apatinib and anti-angiogenic targeting;60 patients in the observation group were treated with TACE and apatinib,and both groups were continuously treated for 3 months.Serum VEGF concentrations and their clinical efficacy were compared between the two groups.RESULTS After 3 months of treatment,the serum VEGF concentration in the observation group was(126.08±12.35)pg/ml and(181.52±11.7)pg/ml in the control group,with a significant difference(t=25.212,P<0.05).The overall treatment effect of the patients in the observed group was better than that in the control group,which was statistically significant(χ^(2)=6.314,P<0.05).After treatment,the objective response rate and disease control rate were 43.4%and 73.4%,respectively,and 25.0%and 55.0%,respectively,which were significant(χ^(2)=4.483,4.385,P<0.05).After treatment,the progression-free survival period was(14.36±1.87)months and patients(10.25±1.45)months,which was significantly significant(t=13.454,P<0.05).CONCLUSION TACE combined with apatinib in patients with unresectable gastric cancer liver metastasis has better clinical efficacy than apatinib alone,and is beneficial to prolong the patient survival cycle.