盐酸安罗替尼治疗晚期非小细胞肺癌的临床观察

目的:探讨盐酸安罗替尼治疗晚期非小细胞肺癌(non-small lung cancer,NSCLC)的临床疗效及不良反应。方法:回顾性分析2017年6月至2019年1月徐州医科大学附属医院收治的三线治疗及以上的晚期NSCLC,应用盐酸安罗替尼治疗的45例患者的临床资料,综合评价患者的疗效和无进展生存期(progression-free survival,PFS)以及不良反应情况。结果:共纳入45例患者,将患者分为安罗替尼单药组(24例)与安罗替尼联合用药组(21例),其中联合白蛋白结合型紫杉醇化疗17例,联合纳武单抗免疫治疗4例。在45例患者中,部分缓解(partial remission,PR)占4.4%(2/45),疾病稳定(stable disease,SD)占88.9%(40/45),疾病进展(progressive disease,PD)占6.7%(3/45),客观有效率(objective response rate,ORR)为4.4%,疾病控制率(disease control rate,DCR)为93.3%。45例患者的中位PFS为3.70个月,经log-rank检验结果显示不同治疗方案差异有统计学意义(P<0.05)。其中单药组患者中位PFS为3.30个月,联合用药组患者中位PFS为5.30个月,联合用药组PFS优于单药组。不良反应主要包括乏力、高血压、食欲不振、手足综合征等,其中3级不良事件包括高血压、手足综合征及骨髓抑制,未发现4级及以上的不良事件。结论:盐酸安罗替尼在三线治疗及以上的晚期NSCLC的治疗中,具有较好的疾病控制及生存获益,且不良反应相对可控。

Clinical observation of anlotinib hydrochloride in the treatment of advanced non-small cell lung cancer

Objective: To investigate the clinical efficacy and adverse reactions of anlotinib in the treatment of advanced non-small cell lung cancer(NSCLC). Methods: The clinical data of 45 patients with advanced non-small cell lung cancer who failed in multi-line treatment and poor tolerance to anti-tumor treatment in the affiliated Hospital of Xuzhou Medical University from June 2017 to January 2019 were analyzed retrospectively. The efficacy, progression-free survival(PFS) and adverse reactions of the patients were evaluated comprehensively. Results: A total of 45 patients were enrolled, including 24 cases in a single group and 21 cases in a combination group(17 cases combined with albumin-bound paclitaxel chemotherapy and 4 cases combined with nivolumab immunotherapy). Among the 45 patients, partial remission(PR) accounted for 4.4%(2/45), stable disease(SD) accounted for 88.9%(40/45), progressive disease(PD) accounted for 6.7%. The objective response rate(ORR) was 4.4%, and the disease control rate(DCR) was 93.3%. The median PFS of 45 patients was 3.70 months. The survival rate of patients with different treatment regimens and short-term effects was significantly different from that of patients with short-term efficacy(P<0.05). Th e results of log-rank test showed that there was significant difference in the survival rate of patients with different treatment regimens and short-term effects. Th e PFS in the single drug group was 3.30 months, and the PFS in the combination group was 5.30 months. Th e PFS in the combination group was bett er than that in the single drug group. Th e adverse reactions of 45 patients included hypertension, fatigue, thyroid dysfunction, hand and foot syndrome, and so on. Th e common adverse events of grade 3 included hypertension, myelosuppression and hand and foot syndrome. No adverse events of grade 4 or above were found in this study. Conclusion: Anlotinib has bett er disease control and survival benefits in advanced non-small cell lung cancer patients with failed second-line treatment, and the adverse reactions are relatively small.