阿帕替尼治疗晚期非小细胞肺癌不良反应的护理
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摘要
目的探讨阿帕替尼治疗晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)的疗效及不良反应,总结护理经验。方法收集2016年1月-2018年1月本院收治的32例接受阿帕替尼治疗的晚期NSCLC患者,治疗1个月后观察疗效,同时监测患者治疗期间出现的不良反应,并做好针对性护理工作。结果 32例服用阿帕替尼患者中, 5例部分缓解(partial remission,PR),20例稳定(stable disease,SD),7例部分疾病进展(progressive disease,PD),总体有效率为15.6%,疾病控制率为78.1%。阿帕替尼治疗不良反应:19例(占59.4%)患者发生高血压,11例(占34.4%)患者发生蛋白尿,10例(31.3%)患者发生手足综合征,7例(占21.9%)患者发生口腔黏膜炎,4例(占12.5%)患者发生血小板减少, 3例(占9.4%)患者发生贫血,2例(占6.3%)患者发生中性粒细胞减少。结论阿帕替尼治疗晚期NSCLC疗效确切,治疗过程分析不良反应发生的原因,并给予针对性的护理措施,减轻患者不良反应,提高治疗耐受性,从而让患者顺利度过治疗过程。
Objective To investigate the efficacy and safety of apatinib in the treatment of advanced non-small cell lung cancer(NSCLC) and summarize nursing experience. Methods The histories of 32 consecutive patients with advanced NSCLC treated with apatinib from January 2016 to January 2018 were retrospectively reviewed and analyzed. After one-month treatment, efficacy and adverse reactions were regularly monitored and targeted nursing cares were well implemented. Results Among 32 patients treated with apatinib, 5 had partial remission(PR), 20 stable disease(SD), and 7 progressive disease(PD). The overall effective rate was 15.6%, and the disease control rate was 78.1%. Adverse reactions of apatinib included: hypertension in 19 patients(59.4%), proteinuria in 11 patients(34.4%), hand-foot syndrome in 10 patients(31.3%), oral mucositis in 7 patients(21.9%), thrombocytopenia in 4 patients(12.5%), anemia in 3 patients(9.4%) and neutropenia in 2 patients(6.3%). Conclusions Apatinib is effective in the treatment of advanced NSCLC. Analyzing the causes of adverse reactions and giving targeted nursing cares can reduce the incidence of adverse reactions, alleviate the pain of patients, and successfully complete the treatment.
Objective To investigate the efficacy and safety of apatinib in the treatment of advanced non-small cell lung cancer(NSCLC) and summarize nursing experience. Methods The histories of 32 consecutive patients with advanced NSCLC treated with apatinib from January 2016 to January 2018 were retrospectively reviewed and analyzed. After one-month treatment, efficacy and adverse reactions were regularly monitored and targeted nursing cares were well implemented. Results Among 32 patients treated with apatinib, 5 had partial remission(PR), 20 stable disease(SD), and 7 progressive disease(PD). The overall effective rate was 15.6%, and the disease control rate was 78.1%. Adverse reactions of apatinib included: hypertension in 19 patients(59.4%), proteinuria in 11 patients(34.4%), hand-foot syndrome in 10 patients(31.3%), oral mucositis in 7 patients(21.9%), thrombocytopenia in 4 patients(12.5%), anemia in 3 patients(9.4%) and neutropenia in 2 patients(6.3%). Conclusions Apatinib is effective in the treatment of advanced NSCLC. Analyzing the causes of adverse reactions and giving targeted nursing cares can reduce the incidence of adverse reactions, alleviate the pain of patients, and successfully complete the treatment.
引文
[1]方申存,张映铭,张梅玲.中性粒细胞与淋巴细胞比率在评估晚期非小细胞肺癌患者预后的价值[J].临床肺科杂志,2018,23(7):1202-1209.
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[10]俞智敏,陈美华,张沂平,等.甲磺酸阿帕替尼治疗晚期肺癌不良反应的护理观察[J].中国生化药物杂志,2017,9(37):314-316.
[11]秦叔逵,李进.阿帕替尼治疗胃癌的临床应用专家共识[J].临床肿瘤学杂志,2015,9(20):841-847.
[12]LI J, QIN S K, XU J,et al. Randomized, Double-blind,placebo-controlled phase iii trial of apatinib in patients with chemotherapy-refractory advanced or metastatic adenocarcinoma of the stomach or gastroesophageal junction[J]. J Clin Oncol,2016,34(13):1448-1454.
[13]张亦芹,王蕊.替吉奥联合阿帕替尼治疗晚期胃癌不良反应的观察和护理[J].护士进修杂志,2018,33(2):138-139.
[14]徐慧颖,李亚洁,廖晓艳.口腔黏膜炎护理研究进展[J].护理研究,2008,17(3):1505-1507.
[15]韦汝琼,李高华,卢晓,等.培美曲塞维持治疗晚期非小细胞肺癌的不良反应观察及护理[J].现代临床护理,2015,14(5):48-50.
[2]BRADBURY P, SIVAJOHANATHAN D, CHAN A, et al.Postoperative adjuvant systemic therapy in completely resected non-small-cell lung cancer:a systematic review[J]. Clin Lung Cancer,2017,18(3):259-273.
[3]ZHAO Y,ADJEIA A A. targeting angiogenesis in cancer therapy:moving beyond vascular endothelial growth factor[J].Oncologist, 2015,20(6):660-673.
[4]SONG Z B, YU X M, LOU G Y, et al.Salvage treatment with apatinib for advanced non-small-cell lung cancer[J].Onco Targets Ther,2017,10(3):1821-1825.
[5]杨学宁,吴一龙.实体瘤治疗疗效评价标准一REClST[J].循证医学,2004,4(2):85-91.
[6]TROTTI A,COLEVAS A D,SETSER A,et al. CTCAE v3.0:development of a comprehensive grading system for the adverse effects of cancer treatment[J]. Semin Radiat Oncol,2003,13(3):176-181.
[7]LIN C,WANG S S,XIE W W,et al. Apatinib inhibits cellular invasion and migration by fusion kinase KIF5BRET via suppressing RET/Src signaling pathway[J].Oncotarget,2016,7(37):59236-59244.
[8]WU F Y, ZHANG S J, XIONG A W,et al.A phase ii clinical trial of apatinib in pretreated advanced non-squamous non-small-cell lung cancer[J]. Clin Lung Cancer,2018,19(6):e831-e842.
[9]FANG S C, ZHANG M L, WEI G Q,et al.Apatinib as a third-or further-line treatment in patients with advanced NSCLC harboring wild-type EGFR[J].Oncotarget,2017,9(6):7175-7181.
[10]俞智敏,陈美华,张沂平,等.甲磺酸阿帕替尼治疗晚期肺癌不良反应的护理观察[J].中国生化药物杂志,2017,9(37):314-316.
[11]秦叔逵,李进.阿帕替尼治疗胃癌的临床应用专家共识[J].临床肿瘤学杂志,2015,9(20):841-847.
[12]LI J, QIN S K, XU J,et al. Randomized, Double-blind,placebo-controlled phase iii trial of apatinib in patients with chemotherapy-refractory advanced or metastatic adenocarcinoma of the stomach or gastroesophageal junction[J]. J Clin Oncol,2016,34(13):1448-1454.
[13]张亦芹,王蕊.替吉奥联合阿帕替尼治疗晚期胃癌不良反应的观察和护理[J].护士进修杂志,2018,33(2):138-139.
[14]徐慧颖,李亚洁,廖晓艳.口腔黏膜炎护理研究进展[J].护理研究,2008,17(3):1505-1507.
[15]韦汝琼,李高华,卢晓,等.培美曲塞维持治疗晚期非小细胞肺癌的不良反应观察及护理[J].现代临床护理,2015,14(5):48-50.