1 空军军医大学唐都医院肿瘤科，西安 710038
目的：评价阿帕替尼治疗方案，在二线化疗失败后晚期胃癌患者人群中的临床疗效及安全性。方法：选取空军军医大学唐都医院2015年9月至2018年8月收治的40例晚期胃癌二线化疗失败的患者，依照是否使用阿帕替尼药物治疗分为治疗组与对照组。治疗组使用阿帕替尼治疗；对照组则给予最优支持治疗。通过对比两组患者在治疗前后的近、远期疗效，不良反应发生率等临床指标，来评估阿帕替尼治疗方案在晚期胃癌患者中的客观疗效及安全性。结果：近期疗效观察中，治疗组客观缓解率(objective remission rate，ORR)、疾病控制率(disease control rate，DCR)优于对照组，DCR差异有统计学意义(80% vs 20%，P<0.05)。远期疗效指标上，治疗组中位总生存期overall survival，OS)6.1个月，中位无进展生存期(progression-free survival，PFS)3.0个月，对照组中位OS 3.7个月，中位PFS 1.8个月，治疗组亦优于对照组(P<0.05)。结论：阿帕替尼治疗方案对二线化疗失败后的晚期胃癌患者具有较为可靠的临床疗效及安全性。部分患者用药后疾病进程延缓，生活质量改善，生存期获得一定程度地延长，临床获益较为显著；同时药物不良反应轻微，大多数患者对药物的耐受情况良好。关键词： 阿帕替尼；晚期胃癌二线化疗失败；临床疗效；安全性
Clinical observation of apatinib in palliative treatment of advanced gastric cancer
CorrespondingAuthor:ZHANG Helong Email: firstname.lastname@example.org
Foundation: This work was supported by the Natural Science Foundation of China (81502402).
Objective: To evaluate the clinical efficacy and safety of apatinib in patients with advanced gastric cancer after the failure of second-line chemotherapy. Methods: From September 2015 to August 2018, 40 patients with advanced gastric cancer who failed second-line chemotherapy were divided into a treatment group and a control group according to whether they were treated with apatinib or not. The treatment group was treated with apatinib, while the control group was treated with optimal support therapy. The objective efficacy and safety of apatinib in patients with advanced gastric cancer were evaluated by comparing the short-term and long-term efficacy and the incidence of adverse reactions between the 2 groups before and after the treatment. Results: In the short-term curative effect observation, the objective remission rate (ORR), disease control rate (DCR) were better than those of the control group, and the differences of DCR were statistically significant (80% vs 20%, P<0.05). In the long-term curative effect index, the median overall survival (OS) of the treatment group was 6.1 months, the median PFS was 3.0 months, the median OS of the control group was 3.7 months, and the median PFS was 1.8 months. The OS and PFS in the treatment group was also superior to those of the control group (P<0.05). Conclusion: The apatinib treatment regimen after the failure of second-line chemotherapy in patients with advanced gastric cancer has a more reliable clinical efficacy and safety. Some patients delay the disease process, the quality of life has improved, the survival time is prolonged to a certain extent, and the clinical benefits are more significant. At the same time, the adverse drug reactions are mild, and most of the patients have good drug tolerance.Keywords： apatinib; failed second-line chemotherapy; advanced gastric cancer; clinical efficacy; safety