阿帕替尼对二线化疗失败的晚期胃癌患者预后的影响

目的 观察阿帕替尼对二线化疗失败的晚期胃癌患者预后的影响.方法 选取2015年4月至2016年5月在成都医学院第一附属医院进行二线及以上化疗方案,且治疗失败的晚期胃癌患者64例,按照随机数字表法分成观察组和对照组,各32例.观察组给予阿帕替尼治疗,对照组给予支持治疗,分析两组患者经不同方案治疗后的疗效及预后情况.结果 经不同方案治疗后,观察组和对照组均有部分患者从治疗中获益,但组间总缓解率(RR)比较,差异无统计学意义(34.38% vs 15.63%,P>0.05),组间控制率(DCR)比较,差异有统计学意义(62.50% vs 31.25%,P<0.05).在血清肿瘤标志物 CEA、CA19-9、CA72-4水平方面比较,对照组较治疗前改善较小,差异无统计学意义(P>0.05);观察组治疗前后改善程度明显优于对照组,且差异有统计学意义(P<0.05).随访12个月,观察组中位PFS和中位 OS均明显长于对照组,差异有统计学意义(P<0.05).在高血压和蛋白尿等不良反应方面比较,观察组(37.50%和21.88%)发生率明显高于对照组(12.50%和0.00%)(P<0.05).结论 阿帕替尼对于二线化疗失败的晚期胃癌患者有一定的治疗价值,可延长患者生存期,其不良反应可通过调节用药量进行改善,相对安全.

Effect of Apatinib on the Prognosis of the Advanced Gastric Cancer Patients with Failed Second-line Chemotherapy

Objective To observe the effect of apatinib on the prognosis of the advanced gastric cancer patients with failed second-line chemotherapy.Methods 64 advanced gastric cancer patients treated with the second-line chemotherapy and failing in the chemotherapy in The First Affiliated Hospital of Chengdu Medical College from April of 2015 to May of 2016 were selected and divided into the observation group and control group according to the random number table method,and each group included 32 cases.The observation group was treated with apatinib,while the control group was given the supportive treatment.The curative effect and prognosis of the two groups were analyzed after treatment.Results Some patients in the two groups benefited from the different regimens.The total remission rate was 34.38% in the observation group and 15.63% in the control group,and the difference between the two groups was not significantly different (P>0.05).The control rate was 62.50% in the observation group and 31.25% in the control group,and the difference between the two groups was significantly different (P<0.05).The levels of CEA,CA19-9 and CA72-4 were not significantly improved after treatment when compared with those before treatment in the control group (P>0.05),and they were significantly better in the observation group than in the control group after treatment (P<0.05).The median PFS and median OS of the observation group were significantly longer than those of the control group after being followed up for 12 months(P<0.05).The incidences of hypertension and albuminuria in the observation group were 37.50% and 21.88% respectively,and they were significantly higher than those in the control group,which were 12.50% and 0.00% respectively (P<0.05).Conclusion Apatinib has certain treatment value for advanced gastric cancer patients with failed second-line chemotherapy,and it can prolong their survival time and reduce their adverse reactions with relative safety by adjusting the dosage.