安罗替尼联合IP方案治疗进展/复发小细胞肺癌临床研究

Clinical Observation of Anlotinib Combined with IP Regimen in the Treatment of Progressive/Recurrent Small Cell Lung Cancer

目的探讨安罗替尼联合IP方案(伊立替康+顺铂)治疗进展/复发小细胞肺癌(SCLC)的临床效果及其作用机制。方法选取医院2019年6月至2021年6月收治的进展/复发SCLC患者97例,按随机数字表法分为对照组(48例)和观察组(49例),两组患者均予IP方案治疗,观察组患者加服盐酸安罗替尼胶囊。两组均以28 d为1个周期,连续治疗2个周期,随访20个月。结果观察组患者的疾病控制率显著高于对照组(P<0.05);观察组患者治疗后的血清癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)、细胞角蛋白19片段(Cyfra21-1)水平及肿瘤代谢体积(MTV)、血容量(BV)、血流量(BF)均显著低于对照组(P<0.05);观察组患者中位无进展生存期(PFS)显著长于对照组(7.5个月比5.5个月,P<0.05);两组患者的不同等级不良反应发生率、生存率均无显著差异(P>0.05)。结论安罗替尼联合IP方案治疗进展/复发SCLC,可降低患者的肿瘤负荷,延长PFS,机制可能与调节肿瘤标志物和改善血流灌注指标有关。

Objective To investigate the clinical efficacy and mechanism of anlotinib combined with IP regimen(irinotecan+cisplatin)in the treatment of progressive/recurrent small cell lung cancer(SCLC).Methods A total of 97 patients with progressive/recurrent SCLC admitted to the hospital from June 2019 to June 2021 were selected and divided into the control group(48 cases)and the observation group(49 cases)by the random number table method.The patients in the two groups were treated with IP regimen,on this basis,the patients in the observation group were treated with Anlotinib Hydrochloride Capsules orally.Both groups were treated continuously for two cycles with 28 d as one cycle and followed up for 20 months.Results The disease control rate(DCR)in the observation group was significantly higher than that in the control group(P<0.05).After treatment,the serum carcinoembryonic antigen(CEA),neuron-specific enolase(NSE)and cytokeratin 19 fragment(Cyfra21-1)levels,metabolic tumor volume(MTV),blood volume(BV)and blood flow(BF)in the observation group were significantly lower than those in the control group(P<0.05).The median progression-free survival(PFS)in the observation group was significantly longer than that in the control group(7.5 months vs.5.5 months,P<0.05).There was no significant difference in the incidence of adverse reactions of different levels and survival rate between the two groups(P>0.05).Conclusion Anlotinib combined with IP regimen in the treatment of progressive/recurrent SCLC can reduce the tumor burden and prolong the PFS of patients.The mechanism may be related to the regulation of tumor markers and improvment of blood perfusion-related indexes.