多西他赛联合阿帕替尼二线治疗非鳞癌非小细胞肺癌的有效性及安全性分析

  目的   观察多西他赛联合阿帕替尼二线治疗晚期非鳞癌非小细胞肺癌的疗效及安全性。   方法   选取2015年2月至2016年8月平顶山市第一人民医院收治的符合标准的晚期非小细胞肺癌患者39例，随机进入研究组和对照组。研究组接受多西他赛60 mg/m2，d1，甲磺酸阿帕替尼500 mg/d，d1~21，21 d为1个周期。对照组接受多西他赛单药化疗，直到疾病进展（progressive disease，PD）或不良反应不可耐受。分析两组患者的疾病控制率（disease control rate，DCR）、不良事件发生率、无进展生存时间（progression-freesurvival，PFS）。   结果   中位随访时间4.6个月，研究组和对照组的DCR率分别为63.2%和30.0%，两组比较具有统计学意义（P=0.039）；研究组最常见的3~4级不良事件为血液学毒性（47.3%），与对照组（15%）比较差异具有统计学意义（P=0.032）。研究组和对照组的中位PFS分别为5.6个月（95%CI:4.8~6.3）和3.0个月（95%CI:1.8~4.1），两者比较差异有统计学意（χ2=4.17，P=0.04）。   结论   多西他赛联合阿帕替尼二线治疗晚期非鳞癌非小细胞肺癌不良反应可控，可显著提高DCR及PFS。 

Efficacy and safety of docetaxel plus apatinib as a second-line treatment for advanced non-squamous non-small cell lung cancer

Objective:To observe the efficacy and safety of docetaxel plus apatinib as a second-line treatment for advanced non-squa-mous non-small cell lung cancer. Methods:From February 2015 to August 2016, 39 eligible patients were randomly assigned to experi-mental arm (19 cases) and control arm (20 cases). Patients in the experimental arm received 60 mg/m2 d1 docetaxel and 500 mg d1-21 apatinib for a 21-day cycle until disease progression or unacceptable toxicity occurred. Patients in the control arm received chemother-apy only. Disease control rate (DCR), incidence of adverse event, and progression-free survival (PFS) were analyzed. Results:The dis-ease control rates (DCR) in the experimental and control arms were 63.2% and 30.0%, respectively, with statistical difference (P=0.039). The experimental arm experienced many grades 3-4 hematologic adverse events with statistical difference (P=0.032). The medi-an PFS values were 5.6 months (95% CI=4.8-6.3) and 3.0 months (95% CI=1.8-4.1) with statistical difference (P=0.04). Conclusion:Docetaxel plus apatinib can be delivered safely with careful monitoring for the treatment of advanced non-squamous non-small cell lung cancer, and this treatment can significantly improve the DCR and PFS.