安罗替尼联合经典EC/EP方案一线治疗小细胞肺癌的临床研究

Clinical study of anlotinib combined with classic EC/EP regimen in the first-line treatment of small cell lung cancer

目的探讨安罗替尼联合经典EC/EP方案一线治疗小细胞肺癌(SCLC)的效果。方法回顾性分析我院肿瘤内一科2019年3月~2020年9月收治的30例SCLC患者,均给予口服安罗替尼+经典EC/EP方案一线治疗,通过影像学、血液学等检查手段,观察和评估联合治疗的疗效,同时监测药物相关不良反应,以评价联合用药的安全性。结果在所有患者中,客观缓解率(ORR)为73.3%,疾病控制率(DCR)为93.3%,中位无进展生存期(mPFS)为6.0个月。相较于治疗前,治疗6个月后肿瘤标志物神经元特异性烯醇化酶(NSE)和癌胚抗原(CEA)的水平均显著下降(P<0.05)。常见的不良反应为骨髓抑制(53.3%),高血压(40.0%),高甘油三酯血症(40.0%),蛋白尿(13.3%),促甲状腺激素增高(33.3%),手足综合征(16.7%),腹泻(13.3%),食欲下降(46.7%),恶心、呕吐(33.3%),疲劳(13.3%)和体重减轻(16.7%)。结论安罗替尼联合经典EC/EP方案一线治疗SCLC的ORR、DCR较高,可明显降低肿瘤标志物水平,不良反应较少,患者耐受性良好,值得增加患者样本量以进行更深入的研究。

Objective To investigate the effect of anlotinib combined with classic EC/EP regimen in the first-line treatment of small cell lung cancer(SCLC).Methods Retrospective analysis of 30 patients with SCLC admitted to the first department of oncology in our hospital from March 2019 to September 2020 was performed.All patients were given oral anlotinib+classic EC/EP regimen as first-line treatment.The efficacy of the combined treatment was observed and evaluated by imaging,hematology and other examination methods.At the same time,drug-related adverse reactions were monitored to evaluate the safety of the combination.Results In all patients,the objective response rate(ORR)was 73.3%,the disease control rate(DCR)was 93.3%,and the median progression-free survival(mPFS)was 6.0 months.Compared with before treatment,the levels of tumor markers neuron-specific enolase(NSE)and carcinoembryonic antigen(CEA)were significantly decreased after 6 months of treatment(P<0.05).The common adverse reactions were bone marrow suppression(53.3%),hypertension(40.0%),hypertriglyceridemia(40.0%),proteinuria(13.3%),increased thyroid stimulating hormone(33.3%),hand-foot syndrome(16.7%),diarrhea(13.3%),loss of appetite(46.7%),nausea and vomiting(33.3%),fatigue(13.3%)and weight loss(16.7%).Conclusion Anlotinib combined with classic EC/EP regimen has higher ORR and DCR in the first-line treatment of SCLC,which can significantly reduce the level of tumor markers,with fewer adverse reactions and good tolerance of patients.It is worth increasing the sample size of patients for further study.