低剂量阿帕替尼联合热疗治疗晚期二线治疗失败胃癌的临床疗效评价

Clinical Efficacy Evaluation of Low-dose Apatinib Combined with Hyperthermia in the Treatment of Advanced Gastric Cancer after Failure of Second-line Treatment

目的评估低剂量阿帕替尼联合热疗应用于二线治疗失败后的晚期胃癌患者的临床疗效和安全性。方法随机选取2020年12月—2021年12月扬州大学附属靖江市人民医院收治的80例二线治疗失败的晚期胃癌患者为研究对象,根据随机数表法分为联合组和靶向治疗组,各40例,靶向治疗组患者口服阿帕替尼250 mg/d治疗,联合组患者在对照组基础上联合热疗,观察两组患者的临床疗效、不良反应、KPS及癌痛评分。结果联合组DCR(90.0%)优于靶向治疗组(72.5%),差异有统计学意义(χ^(2)=4.021,P=0.045)。联合组与靶向治疗组的不良反应发生率比较,差异无统计学意义(P>0.05)。联合组KPS评分好转率(65.0%)优于靶向治疗组(37.5%),差异有统计学意义(χ^(2)=6.054,P=0.014)。联合组癌痛评分低于靶向治疗组,差异有统计学意义(P<0.001)。结论对于晚期的胃癌患者采用口服低剂量阿帕替尼联合热疗具有较好的临床治疗效果,且不良反应发生率低,能够确保抗肿瘤治疗的有效性和安全性,可作为临床晚期胃癌患者的一种治疗选择。

Objective Evaluation of the clinical efficacy and safety of low-dose apatinib combined with hyperthermia in advanced gastric cancer patients who have failed second-line treatment.Methods 80 advanced gastric cancer patients who failed second line treatment at the Jingjiang People's Hospital Affiliated to Yangzhou University from December 2020 to December 2021 were randomly selected as the research subjects.They were randomly divided into a combination group and a targeted treatment group,with 40 patients in each group.The targeted treatment group received 250 mg/d of apatinib orally,while the combination group received hyperthermia on the basis of the control group.The clinical efficacy,adverse reactions,KPS,and cancer pain scores of the two groups of patients were observed.Results The DCR of the combination group(90.0%)was better than that of the targeted treatment group(72.5%),the difference was statistically significant(χ^(2)=4.021,P=0.045).There was no statistically significant difference in the incidence of adverse reactions between the combination group and the targeted treatment group(P>0.05).The improvement rate of KPS score in the combined group(65.0%)was better than that in the targeted treatment group(37.5%),the difference was statistically significant(χ^(2)=6.054,P=0.014).The cancer pain score of the combined group was lower than that of the targeted treatment group,the difference was statistically significant(P<0.001).Conclusion The implementation of low-dose apatinib combined with hyperthermia can achieve higher clinical efficacy and safety.Therefore,this regimen is expected to become the treatment option for patients with advanced third-line gastric cancer.