贝伐株单抗与阿帕替尼分别联合替莫唑胺治疗复发性高级别脑胶质瘤的近期及远期疗效分析

Short term and long-term efficacy of bevacizumab monoclonal antibody and apatinib combined with temozolomide in treatment of recurrent high-grade glioma

目的探究贝伐株单抗与阿帕替尼分别联合替莫唑胺(TMZ)治疗复发性高级别脑胶质瘤的近期及远期疗效。方法选取2018年3月—2020年3月武汉市第一医院107例复发性高级别脑胶质瘤患者作为研究对象,按照随机数字表法分为贝伐株单抗组(53例)和阿帕替尼组(54例)。贝伐珠单抗组予以贝伐珠单抗联合TMZ治疗;阿帕替尼组予以阿帕替尼联合TMZ治疗。评估两组治疗3个周期后的临床疗效,比较两组血清VEGF、EGFR水平,分析给药期间两组的药物毒性反应,并随访记录两组总生存期(OS)和2年生存率。结果阿帕替尼组治疗后客观缓解率和疾病控制率高于贝伐珠单抗组(P<0.05);贝伐珠单抗组治疗前后血清VEGF和EGFR的差值高于阿帕替尼组(P<0.05);贝伐珠单抗组治疗后血小板降低率高于阿帕替尼组(P<0.05);贝伐珠单抗组治疗后高血压发生率低于阿帕替尼组(P<0.05);截止随访时间,贝伐珠单抗组OS为13.5个月,2年生存率22.64%,阿帕替尼组OS为17个月,2年生存率44.44%,Kaplan-Meier生存曲线显示,阿帕替尼组生存率高于贝伐珠单抗组(P<0.05)。结论相对于贝伐珠单抗联合TMZ治疗方案,阿帕替尼联合TMZ治疗复发性高级别脑胶质瘤疗效更为优越,且可延长患者生存期。

Objective To explore the short term and the long-term efficacy of Bevacizumab monoclonal antibody and Apatinib combined with temozolomide(TMZ)in treatment of recurrent high-grade glioma.Methods From March 2018 to March 2020,107 patients with recurrent glioma cells treated in our hospital were randomly divided into Bevacizumab group and Apatinib group.Fifty-three patients in Bevacizumab group were treated with Bevacizumab combined with TMZ,and 54 patients in Apatinib group were treated with Apatinib combined with TMZ.The clinical efficacy of the two groups after three cycles of treatment was evaluated,the expression level of serum tumor markers was compared,the drug toxicity during administration was analyzed,and the median survival(OS)and 2-year survival rate of the two groups were recorded.Results After treatment,the objective remission rate and disease control rate in Apatinib group were higher than those in Bevacizumab group(P<0.05).The difference of serum VEGF and EGF levels in Bevacizumab group was higher than that in Apatinib group(P<0.05).The rate of thrombocytopenia in Bevacizumab group was higher than that in Apatinib group(P<0.05).The incidence of hypertension in Bevacizumab group was lower than that in Apatinib group(P<0.05).Up to the follow-up time,OS in Bevacizumab group was 13.5 months,and the 2-year survival rate was 22.64%.The OS of Apatinib group was 17 months,and the 2-year survival rate was 44.44%.The survival curve of Apatinib group was higher than that of Bevacizumab group(P<0.05).Conclusion Compared with Bevacizumab combined with TMZ,Apatinib combined with TMZ is more effective in the treatment of recurrent high-grade glioma,and can prolong the survival time of patients.