安罗替尼联合白蛋白结合型紫杉醇治疗晚期肺癌的临床疗效及安全性

Clinical efficacy and safety of anlotinib combined with albumin-bound paclitaxel in treatment of advanced lung cancer

目的观察安罗替尼联合白蛋白结合型紫杉醇治疗晚期肺癌患者的临床疗效和不良反应。方法选取2018年7月至2020年7月该院收治的至少经过一线方案治疗的34例晚期肺癌患者为研究对象,采用安罗替尼联合白蛋白结合型紫杉醇治疗21 d方案,持续用药至疾病进展(PD)或不能耐受。第2周期后复查影像学评价疗效。比较治疗前后患者卡氏评分(KPS)及血清血管内皮生长因子(VEGF)水平。通过收集患者的基本临床资料、无进展生存期、总生存期及相关不良反应等资料,评估治疗的临床疗效及不良反应。结果治疗2个周期后,34例患者中完全缓解(CR)0例、部分缓解(PR)10例、疾病稳定(SD)10例、PD 14例,客观有效率(ORR)为29.41%(10/34),疾病控制率(DCR)为58.82%(20/34),中位无进展生存时间为6.4个月,中位生存时间为11.9个月。近期疗效与患者性别、年龄、吸烟史、既往抗血管生成治疗及既往紫杉类药物化疗无明显相关性(P>0.05),与肿瘤病理类型、肿瘤分期及安罗替尼治疗线数有相关性(P<0.05)。与治疗前比较,治疗后KPS升高[(77.35±9.34)分vs.(74.61±8.75)分],VEGF水平降低[(217.71±61.04)mg/L vs.(440.17±97.62)mg/L],差异有统计学意义(P<0.05)。治疗期间多为1~2级不良反应,包括白细胞减少、脱发、乏力、外周神经毒性、血红蛋白减少、继发性高血压和恶心呕吐,未发生4级不良反应。结论安罗替尼联合白蛋白结合型紫杉醇可改善晚期肺癌患者的预后。

Objective To observe the clinical efficacy and adverse reactions of anlotinib combined with albumin-bound paclitaxel in treating the patients with advanced lung cancer.Methods Thirty-four patients with advanced lung cancer treated by at least first line scheme in this hospital from July 2018 to July 2020 were selected as the study subjects.The anlotinib combined with albumin-bound paclitaxel for 21 d scheme was adopted,the medication was sustained until progression disease(PD)or intolerance.The imaging was reexamined after the second treatment cycle and the efficacy was evaluated.The Karnofsky(KPS)score and serum vascular endothelial growth factor(VEGF)levels were compared between before and after treatment.The basic clinical data,progression free survival(PFS),overall survival(OS),related adverse reactions and other data of the patients were collected to evaluate the clinical efficacy and adverse reactions.Results After treatment for 2 cycles,among 34 cases,no case achieved complete remission(CR),10 cases had partial remission(PR),10 cases were in stable disease(SD)and 14 cases were in PD.The objective response rate(ORR)was 29.41%(10/34)and the disease control rate(DCR)was 58.82%(20/34).The median PFS was 6.4 months and the median OS was 11.9 months.The short-term clinical efficacy had no significant correlation with the gender,age,smoking history,prior paclitaxel-based chemotherapy and previous anti-angiogenic therapy(P>0.05),but had the correlation with the pathological type,tumor stage and the number of anlotinib treatment lines(P<0.05).Compared with before treatment,the KPS score after treatment was increased[(77.35±9.34)points vs.(74.61±8.75)points],the serum VEGF was decreased[(217.71±61.04)mg/L vs.(440.17±97.62)mg/L],and the differences were statistically significant(P<0.05).Most of adverse reactions during treatment were the grade 1-2,including leukopenia,fatigue,alopecia,peripheral neurotoxicity,hemoglobin decrease,secondary hypertension,and nausea and vomiting.No grade 4 adverse reactions occurred.Conclusion Anlotinib combined with albumin-bound paclitaxel could improve the prognosis of the patients with advanced lung cancer.