阿帕替尼联合常规化疗治疗晚期胃癌的临床效果

Clinical outcomes of apatinib in combination with standard chemotherapy for advanced gastric cancer

目的观察阿帕替尼联合常规化疗治疗晚期胃癌的临床效果。方法选取2020年1月—2021年12月福建省肿瘤医院收治的确诊晚期胃癌拟行FOLFOX方案治疗的患者50例,采用随机数字表法分为观察组和对照组,各25例。对照组接受常规干预并予FOLFOX方案治疗,观察组在对照组基础上联用甲磺酸阿帕替尼片治疗,4个周期结束时比较2组近期疗效,治疗前与治疗4个周期后血清学相关指标[基质细胞衍生因子-1(SDF-1)、血清缺氧诱导因子-1α(HIF-1α)、转化生长因子-β1(TGF-β1)、肿瘤坏死因子-α(TNF-α)、白介素-10(IL-10)]、不良反应及治疗后12个月和24个月患者生存率。结果观察组患者近期有效率为96.00%,高于对照组的72.00%(χ^(2)=5.357,P=0.021);治疗4个周期后,2组SDF-1、HIF-1α、TGF-β1、TNF-α、IL-10水平较治疗前下降,且观察组低于对照组(P<0.01);观察组不良反应总发生率为4.00%,低于对照组的32.00%(χ^(2)=6.640,P=0.010);观察组随访12个月、24个月时患者生存率均显著高于对照组(P<0.05或P<0.01)。结论阿帕替尼联合常规化疗治疗晚期胃癌的近期临床效果肯定,对于改善患者血清学相关指标,延长生存期均有积极影响,且用药安全性较高。

Objective To investigate the clinical outcomes of combining apatinib with standard chemotherapy for advanced gastric cancer.Methods A total of 50 patients with advanced gastric cancer who were scheduled to receive FOLFOX regimen and admitted to Fujian Cancer Hospital between January 2020 and December 2021 were randomly divided into observation group and control group(n=25 per group)using a random number table.The control group received standard care and FOLFOX regimen,while the observation group received additional apatinib mesylate tablets on top of the control group′s treatment.After 4 cycles of treatment,the short-term efficacy,changes in serum levels of related indicators(SDF-1,HIF-1α,TGF-β1,TNF-α,IL-10)before and after treatment,adverse reactions,as well as the 12-month and 24-month survival rates of patients in the two groups were compared.Results The objective response rate was significantly higher in the observation group(96.00%)compared to the control group(72.00%)(χ^(2)=5.357,P=0.021).After 4 cycles of treatment,the levels of SDF-1,HIF-1α,TGF-β1,TNF-αand IL-10 decreased in both groups compared with baseline,and the levels in the observation group were significantly lower than those in the control group(all P<0.01).The overall incidence of adverse events was significantly lower in the observation group(4.00%)compared to the control group(32.00%)(χ^(2)=6.640,P=0.010).The 12-month and 24-month overall survival rates were significantly higher in the observation group compared to the control group(both P<0.05).Conclusion The recent clinical outcomes of apatinib combined with conventional chemotherapy for advanced gastric cancer are promising.This combination therapy has shown positive effects on improving serum-related biomarkers and prolonging overall survival,with a favorable safety profile.