阿帕替尼治疗6例晚期难治性卵巢癌的临床观察

  目的  观察甲磺酸阿帕替尼治疗常规治疗失败的晚期卵巢癌患者的临床疗效及不良反应。  方法  选取天津医科大学第二医院2015年6月至2016年10月收治的6例常规治疗失败的晚期难治性卵巢癌患者，通过观察患者口服甲磺酸阿帕替尼后的影像学检查、NSE、CEA、CA125等肿瘤标记物的变化来评估近期疗效。  结果  6例患者平均年龄为55（48~71）岁。中、低分化浆液性囊腺癌4例，交界性乳头状囊腺瘤癌变1例，透明细胞癌1例。6例接受甲磺酸阿帕替尼治疗的患者中，完全缓解（complete response，CR）0例，部分缓解（partial response，PR）2例，疾病稳定（stable disease，SD）1例，疾病进展（progressive disease，PD）3例。客观有效率（objective response rate，ORR）33%（2/6），疾病控制率（disease control rate，DCR）50%（3/6）。服药的所有患者安全性良好，主要不良反应为手足综合征与高血压，且程度较轻，经对症治疗后好转。  结论  甲磺酸阿帕替尼治疗常规治疗失败的晚期难治性卵巢癌患者初步观察具有一定的疗效，且安全性良好。今后仍需进一步探索该药治疗卵巢癌的机制，为晚期卵巢癌患者寻求更为有效的治疗策略。 

Clinical observations of six advanced refractory ovarian cancer cases treated with apatinib

  Objective  To analyze the efficacy and the adverse reactions of conventional treatment-failed advanced refractory ovarian cancer cases after treatment with apatinib.  Methods  Six patients enrolled in the Second Hospital of Tianjin Medical University from June 2015 to October 2015 received treatment with apatinib. Treatment efficacy was evaluated by imaging and analysis of tumor markers, including CA125, CEA, and NSE.  Results  The age range of the six patients was 48-71 years (median: 55 years). Their histopathological subtypes included poorly differentiated serous cystadenocarcinoma (4/6), borderline papillary adenoma (1/6), and clear cell carcinoma (1/6). Clinical evaluation of patients revealed no cases with complete remission, two cases with partial response, one case with stable disease, and three cases with progressive disease. The objective response rate was 33% (2/6) and the disease control rate was 50% (3/6). In all patients, the main side effects were hypertension and hand-foot syndrome, which were controlled.  Conclusions  The treatment of conventional treatment-failed advanced refractory ovarian cancer with apatinib has better exact effects, and medical toxicity can be controlled. In the future, to seek more effective treatment strategies, the mechanism of apatinib in the treatment of advanced ovarian cancer should be further explored.