帕博利珠单抗联合阿帕替尼对晚期胃癌化疗患者疾病缓解率及生存情况的影响

Effects of pabolizumab Combined with Apatinib on Remission Rate and Survival in Patients with Advanced Gastric Cancer Undergoing Chemotherapy

目的:观察帕博利珠单抗联合阿帕替尼对晚期胃癌化疗患者疾病缓解率及生存情况的影响,探讨晚期胃癌治疗方案的选择。方法:回顾性分析2018年8月至2021年1月海南西部中心医院收治的107例晚期胃癌患者病例资料,根据不同治疗方案将患者分为观察组52例(帕博利珠单抗+阿帕替尼+化疗)和对照组55例(单纯化疗+阿帕替尼)。统计两组患者治疗3个周期时的客观缓解率(ORR),以2023年1月31日为随访终点,统计两组患者的总生存期(OS)和无进展生存期(PFS),统计治疗期间的不良反应。结果:观察组患者的ORR为59.62%(31/52),高于对照组的36.36%(20/55),差异有统计学意义(P<0.05)。两组患者的疾病控制率比较,差异无统计学意义(P>0.05)。观察组患者的OS、PFS均长于对照组,差异均有统计学意义(P<0.05)。观察组患者消化道反应发生率高于对照组,差异有统计学意义(P<0.05);两组患者其他不良反应发生率比较,差异均无统计学意义(P>0.05)。结论:帕博利珠单抗联合阿帕替尼作为三线治疗方案能够提高晚期胃癌化疗患者的疾病缓解率,延长患者生存时间,长期应用会对患者消化功能造成一定影响,但并未增加其他不良反应的发生。

OBJECTIVE:To observe the effects of pabolizumab combined with apatinib on remission rate and survival in patients with advanced gastric cancer undergoing chemotherapy,and to probe into the selection of treatment for advanced gastric cancer.METHODS:Clinical data of 107 patients with advanced gastric cancer admitted into Hainan West Central Hospital from Aug.2018 to Jan.2021 were retrospectively analyzed.All patients were divided into 52 cases in the observation group(pabolizumab + apatinib + chemotherapy) and 55 cases in the control group(chemotherapy alone + apatinib) according to different treatment regimens.The objective response rate(ORR) of two groups at 3 cycles of treatment was calculated.With Jan.31st,2023 as the follow-up end point,the overall survival(OS) and progression-free survival(PFS) of two groups were calculated,and the adverse reactions of two groups during treatment was recorded.RESULTS:The ORR of observation group was 59.62%(31/52),higher than 36.36%(20/55) of the control group,with statistically significant difference(P<0.05).There was no statistically significant difference in disease control rate between two groups(P>0.05).The OS and PFS in the observation group were longer than those in the control group,with statistically significant difference(P<0.05).The incidence of digestive tract reaction in the observation group was higher than that in the control group,with statistically significant difference(P<0.05).There was no statistically significant difference in the incidence of other adverse reactions between two groups(P>0.05).CONCLUSIONS:Pabolizumab combined with apatinib as the third line treatment regimens can improve the disease remission rate of patients with advanced gastric cancer undergoing chemotherapy,prolong the survival time of patients.Prolonged application may have some effect on patients' digestive function,yet does not increase the occurrence of other adverse reactions.