阿帕替尼联合替吉奥治疗老年或瘦弱患者晚期胃癌临床研究

目的探讨阿帕替尼联合替吉奥胶囊与单药替吉奥胶囊治疗老年或体型瘦弱患者晚期胃癌的近期疗效与不良反应。方法选取2015年6月至2016年6月收治的老年或体型瘦弱的晚期胃癌患者31例,随机分为两组。采用阿帕替尼片联合替吉奥胶囊治疗者设为A组(n=16);采用单药替吉奥胶囊治疗者设为B组(n=15)。B组给予替吉奥胶囊单药治疗,根据体表面积给药,体表面积<1.25 m~2者,剂量为40 mg/次;体表面积1.25~1.50 m~2者,剂量为早40 mg/次、晚60 mg/次;体表面积>1.50 m~2者,剂量为60 mg/次。患者于早、晚餐后各1次口服,连服14 d,停药14 d,28 d为1个周期。A组口服替吉奥胶囊给药剂量同B组,在替吉奥胶囊单药治疗基础上加用阿帕替尼,根据患者耐受情况给药,起始剂量500 mg/次,耐受良好者逐渐增加剂量至850 mg/次。1次/d口服,28 d为1个周期。两组患者均化疗至少2个周期后评价疗效。结果 A组与B组的有效率分别为43.8%与26.7%,两组间比较,差异有统计学意义(P<0.05)。A组与B组的疾病控制率分别为81.3%与66.7%,两组间比较,差异有统计学意义(P<0.05)。两组患者乏力、血液毒性及消化道毒性等不良反应的发生情况比较,差异无统计学意义(P>0.05);A组口腔黏膜炎发生率(43.7%)高于B组(15.3%),差异有统计学意义(P<0.05)。结论阿帕替尼联合替吉奥治疗老年或体弱患者晚期胃癌疗效确切、安全。

Apatinib combined tegafur in treatment for elderly or emaciated patients with advanced gastric cancer

Objective To investigate the efficacy and toxicity of apatinib combined tegafur(S-1)and single S-1 in elderly or emaciated patients with advanced gastric cancer. Methods Clinical data was selected from 31 patients with advanced gastric cancer admitted from June 2015 to June 2016. Patients were randomly divided into two groups. Patients who were treated with apatinib combined S-1 were in the observation group(n=16);the others who were treated with single S-1 capsule were in the control group(n=15). Patients in the control group were given single S-1 treatment,according to body surface area,body surface area was less than 1. 25 m2 ,the dose was 40 mg/time;body surface area was from 1. 25 m2 to 1. 50 m2 ,the dose was 40 mg/time in the morning and 60 mg/time in the eve-ning;body surface was more than 1. 50 m2 ,the dose was 60 mg/time. Patients took oral medicine twice a day( after breakfast and din-ner) ,continuous medication for 14 days,drug discontinuance for 14 days,28 days for a cycle. The dose of the S-1 in the observation group was the same as that in the control group. At the same time,the observation group was treated with apatinib with a initial meas-urement of 500 mg/time,gradually increasing to 850 mg/time. Patients took orally once a day,28 days for a cycle. To evaluated the chemotherapy after at least two cycles in two groups of patients. Results There was statistically significant difference between the ob-servation group and the control group in effective rate(43. 8% versus 26. 7%)and disease control rate(81. 3% versus 66. 7%)(P<0. 05). Two groups of patients with lack of power,the occurrence of adverse reactions such as blood toxicity and gastrointestinal tract toxicity comparison,there was no statistically significant difference(P>0. 05);the incidence of oral cavity mucous membrane inflam-mation in the observation group(43. 7%)was higher than that in the control group(15. 3%),the difference was statistically significant (P>0. 05). Conclusion Apatinib combined S-1 capsule has definite therapeutic and safe effect on elderly and emaciated patients with advanced gastric cancer.