阿帕替尼治疗小细胞肺癌的临床疗效及安全性

  目的  观察甲磺酸阿帕替尼治疗多线治疗失败的小细胞肺癌的临床疗效及安全性。  方法  对2016年1月至2017年12月哈尔滨医科大学附属肿瘤医院收治的41例既往接受过二线及以上治疗的晚期小细胞肺癌患者的临床资料进行分析。患者口服阿帕替尼250~500 mg/d，直至疾病进展或不良反应不可耐受。分析患者的疾病控制率（disease control rate，DCR）、无疾病进展生存期及不良反应。  结果  41例患者中，客观缓解率（objective response rate，ORR）为12.19%，DCR为80.48%，无疾病进展生存时间为4.1个月。治疗过程中，常见的不良反应为1~3级的高血压和手足综合征，其次为Ⅰ~Ⅱ组蛋白尿和疲乏等，多无需特殊处理，大部分不良反应可通过减少药物剂量得到缓解。  结论  对有条件接受靶向治疗的晚期小细胞肺癌患者，接受阿帕替尼治疗能获得生存期延长。阿帕替尼治疗多线治疗失败的小细胞肺癌值得在临床中进一步探讨。 

Clinical efficacy and safety of apatinib in patients with small cell lung cancer

  Objective  To observe the clinical efficacy and safety of apatinib in the treatment of small-cell lung cancer that has failed multiline therapies.  Methods  We analyzed the clinical data of 41 patients with advanced small-cell lung cancer admitted to our hospital from January 2016 to December 2017 who had previously received more than one line of treatment. Patients took apatinib daily until disease progression or adverse reactions become intolerable. We analyzed the disease control rate, progression survival period, and adverse events.  Results  Among the 41 patients studied, the objective response rate, disease control rate, and progression-free survival were 12.19%, 80.48%, and 4.1 months, respectively. During the treatment, the common adverse events were grade 1-3 hypertension and hand-foot syndrome. Other common side effects were proteinuria and fatigue, mainly of grade 1-2, often without special treatment. Most adverse reactions could be relieved by reducing the drug dosage.  Conclusions  Apatinib therapy can extend the survival period of patients with small-cell lung cancer who are eligible for the therapy. The role of apatinib in the treatment of small-cell lung cancer involving the failure of multiline therapies warrants further discussion in clinical practice.