低剂量甲磺酸阿帕替尼治疗晚期原发性肝癌疗效与安全性

目的甲磺酸阿帕替尼是一种小分子抗血管生成药物。本研究分析低剂量阿帕替尼治疗晚期原发性肝癌的疗效及安全性,并探讨可行性。方法回顾性分析2016-10-27-2018-03-02徐州市中心医院肿瘤内科收治的晚期原发性肝癌20例,阿帕替尼425mg/d,口服,直至病情进展、患者不耐受或患者拒绝用药。总结临床反应率、不良反应及生存情况。结果阿帕替尼作为一线治疗14例,二线治疗6例。所有患者均可评价近期可观疗效,客观缓解率为0,疾病控制率为80%(95%CI为56%~94%),无进展生存期为4.6个月(95%CI为2.1~7.1个月),总生存期为11.1个月(95%CI为5.2~17.0个月),常见3~4级不良反应为血小板减少(30%,6/20)、白细胞减少(20%,4/20)、粒细胞减少(20%,4/20)、高血压(20%,4/20)和上消化道出血(10%,2/20),无治疗相关死亡。结论阿帕替尼425mg/d治疗晚期肝癌有一定疗效,总体耐受性尚可,治疗过程中需严密监测及加强风险评估,及时减量及停药,避免严重不良事件。

Efficacy and safety of low-dose apatinib treatment for advanced primary liver cancer

OBJECTIVE Apatinib is a small anti-angiogenic agent.This study aimed to observe and assess the efficacy and safety of low-dose apatinib in the treament of advanced primary hepatocellular carcinoma.METHODS Twenty patients with advanced primary liver cancer admitted to the Department of Oncology of Xuzhou Central Hospital from2016-10-27 to 2018-03-02 were analyzed retrospectively.Patients were treated with apatinib at 425 mg daily until disease progression or intolerable.RESULTS Fourteen patients received apatinib as first-line treatment and 6 patients as secondline treatment.All patients were evaluated.The objective response rate(ORR)was 0 and the disease control rate(DCR)was 80%.The median progression free survival(mPFS)and median overall survival(mOS)were 4.6 months(95%CI:2.1-7.1 months)and 11.1 months(95%CI:5.2-17.0).The most common adverse events over grade 3 were thrombocytopenia(30%,6/20),neutropenia(20%,4/20)leukopenia(20%,4/20),hypertension(20%,4/20)and upper gastrointestinal bleeding(10%,2/20).There was no treatment-related death.CONCLUSIONS Apatinib 425 mg daily is effective for patients with liver cancer.The toxicities are manageable and tolerable.Apatinib 425 mg/d has a certain curative effect for patients with advanced primary liver cancer.The toxicities are manageable and tolerable.However,it is necessary to assess the risk of bleeding to avoid serious adverse events.