安罗替尼三线以上治疗非小细胞肺癌疗效观察

目的:观察安罗替尼在晚期非小细胞肺癌三线以上治疗中的疗效和不良反应。方法:二线或多线治疗后进展的晚期非小细胞肺癌患者75例（其中55例为二线治疗后，15例为三线治疗后，5例为4线治疗后）。所有患者均给予安罗替尼 12 mg，每天1次口服，连续服用14天，停用1周，每21天重复，直到疾病进展或不能耐受不良反应为止。不能耐受不良反应的患者，根据情况将剂量降至每天10 mg或每天8 mg。每6周复查CT评价疗效。结果:75例患者中，PR 6例，SD 45例，PD 24例，ORR 8.0%，DCR 60.0%，PD 32.0%，PFS和OS分别为5.2个月（95%CI:4.4~6.0）和8.0个月（95%CI:6.1~9.9）。分层结果，45例腺癌中，PR 4例，SD 27例，PD 14例，ORR 8.9%，DCR 68.9%，PD 31.1%。30例鳞状细胞癌中，PR 2例，SD 18例，PD 10例，ORR 6.7%，DCR 66.7%，PD 33.3%。腺癌组与鳞状细胞癌组的DCR比较，P=0.840，无统计学差异，腺癌组与鳞状细胞癌组的PFS分别为4.5个月（95%CI:3.9~5.1）和5.2个月（95%CI:4.2~6.2），Log-Rank P=0.033，有统计学差异，OS分别为6.7个月（95%CI:3.2~10.2）和8.0个月（95%CI:5.9~10.1），Log-Rank P=0.057，无统计学差异。不良反应主要是疲劳、食欲减退、手足综合征、头痛和高血压。结论:安罗替尼三线以上治疗非小细胞肺癌有效，鳞状细胞癌患者的PFS显著高于腺癌患者，不良反应可以耐受。

Effect of anlotinib as the third-line or further-line treatment on non-small cell lung cancer(NSCLC)

Objective:To observe the efficacy and adverse reactions of anlotinib in the third-line or further-line treatment of advanced non-small cell lung cancer(NSCLC).Methods:After two or more lines treatment(55 cases were after second-line treatment,15 cases after third-line treatment,and 5 cases after fourth-line treatment),75 patients with advanced NSCLC received 12 mg of anlotinib once a day for 14 consecutive days,with 1 week of discontinuation,and repeated every 21 days until disease progression or intolerance of adverse reactions.For patients who cannot tolerate adverse reactions,the dose should be appropriately reduced to 10 mg or 8 mg per day.CT was reviewed every 6 weeks to evaluate the efficacy.Results:Among the 75 patients,PR 6,SD 45,PD 24,ORR 8.0%,DCR 60.0%,PD 32.0%.PFS and OS were 5.2 months(95%CI:4.4~6.0)and 8.0 months(95%CI:6.1~9.9),respectively.Stratification results showed that among the 45 adenocarcinoma cases,PR 4,SD 27,PD 14,ORR 8.9%,DCR 68.9%,PD 31.1%.Among the 30 cases of squamous cell carcinoma,PR 2,SD 18,PD 10,ORR 6.7%,DCR 66.7%,PD 33.3%.Comparison of DCR between adenocarcinoma group and squamous cell carcinoma group showed no statistical difference(P=0.840),and the PFS of the adenocarcinoma group and the squamous cell carcinoma group were 4.5 months(95%CI:3.9~5.1)and 5.2 months(95%CI:4.2~6.2),respectively,and Log-Rank P=0.033,with statistical difference,and the OS was 6.7 months(95%CI:3.2~10.2)and 8.0 months(95%CI:5.9~10.1),and Log-Rank P=0.057,without statistical difference.The main adverse reactions were fatigue,loss of appetite,hand and foot syndrome,headache and hypertension.Conclusion:The third-line or further-line treatment of anlotinib for NSCLC was effective,and the PFS of patients with squamous cell carcinoma is significantly higher than that of patients with adenocarcinoma,and adverse reactions can be tolerated.