甲磺酸阿帕替尼治疗晚期胃癌的疗效及安全性分析

目的:观察甲磺酸阿帕替尼治疗晚期胃癌的临床疗效和毒副反应。方法:回顾性分析2016年01月至2018年01月在我院接受二线或以上的单纯化疗或甲磺酸阿帕替尼单独治疗的晚期胃癌患者，单纯化疗组56例作为对照组，甲磺酸阿帕替尼组34例。收集两组患者的一般临床资料，分析其临床近期疗效、无进展生存期和毒副反应。结果:对照组和甲磺酸阿帕替尼组患者在性别、年龄、ECOG评分、肿瘤位置、分化程度和是否手术治疗方面差异无统计学意义（P＜0.05）。对照组患者近期疗效:达到CR、PR和SD的患者分别为0例、5例和10例，甲磺酸阿帕替尼组患者近期疗效:达到CR、PR和SD的患者分别为1例、7例和9例。对照组ORR（8.9%）与甲磺酸阿帕替尼组ORR（23.5%）相比，差异无统计学意义（P=0.056）；对照组DCR（26.8%）显著低于甲磺酸阿帕替尼组DCR（50.0%）（P=0.026）。对照组患者中位无进展生存期显著低于甲磺酸阿帕替尼组（P=0.020）。对照组出现乏力和骨髓抑制的比例显著高于甲磺酸阿帕替尼组（P=0.009，P=0.000）。结论:甲磺酸阿帕替尼二线治疗晚期胃癌与对照组相比近期疗效较好，无进展生存期较长，毒副反应较少，具有较好的疗效和安全性。

Efficacy and safety of apatinib mesylate in the treatment of advanced gastric cancer

Objective:To observe the clinical efficacy and adverse reactions of apatinib in the treatment of advanced gastric cancer.Methods:Clinical data of patients with advanced gastric cancer who received second-line or above chemotherapy alone or apatinib mesylate in our hospital from January 2016 to January 2018 were retrospectively analysed.56 patients in the chemotherapy-only group were used as the control group and 34 patients in the apatinib group.General clinical data of patients were analysed.The clinical short-term efficacy was analysed.Progression-free survival and adverse reactions were analysed.Results:There were no significant differences in thegender,age,ECOG score,tumor location,degree of differentiation,and whether the patients were treated with operative(P<0.05).The short-term efficacy of patients in the chemotherapy group showed cases of CR,PR,and SD were 0,5,and 10,respectively.The short-term efficacy of patients in the apatinib group showed cases of CR,PR,and SDwere 1,7,and 9,respectively.The ORR of 8.9%in the chemotherapy group was not significantly different from the ORRof 23.5%in the apatinib mesylate group(P=0.056).TheDCR rate in the chemotherapy group was 26.8%,which was significantly lower than the DCR rate in the apatinib group(50.0%)(P=0.026).The median progression-free survival of patients in the chemotherapy group was significantly lower than that of the apatinib group(P=0.020).The proportion of fatigue and bone marrow suppression in the control group was significantly higher than that in the apatinib group(P=0.009,P=0.000).Conclusion:The second-line treatment of apatinib for advanced gastric cancer has better short-term efficacy,longer progression-free survival,fewer adverse reactions,and better efficacy and safety compared with the chemotherapy group.