影响阿帕替尼治疗肝癌疗效的因素分析
|
摘要
目的探讨阿帕替尼治疗原发性肝癌的疗效性及安全性。方法回顾性分析40例原发性肝癌患者,给予阿帕替尼250 mg/次,1次/d或者250 mg/次,2次/d口服,425 mg/次,1次/d,直至肿瘤进展或者不能耐受。随访时间为18个月,观察药物不良反应。结果 40例患者疾病控制率(DCR)为60%,中位无进展生存时间(mPFS)为4.5个月,在单因素分析中,ECOG评分、合并治疗及用药后疗效对中位PFS的差异具有统计学意义(P<0.05),性别、年龄、饮酒史、肝炎病史、合并肝硬化失代偿及门脉癌栓情况、Child-Pugh分级、肿瘤个数、肿瘤远处转移情况、AFP水平、阿帕替尼剂量等因素对中位PFS的差异无统计学意义(P>0.05);多因素分析发现疗效评价是影响PFS的独立影响因素。不良反应主要为出血、手足综合征、胃肠道反应、高血压等,多数为Ⅰ级或Ⅱ级,患者能够耐受或者减量后可以耐受。结论阿帕替尼治疗原发性肝癌有效,安全。
Objective To investigate the efficiency and safety of apatinib in the treatment of advanced primary liver cancer.Methods A retrospective analysis of 40 patients with advanced primary liver cancer was made, given apatinib 250 mg/time,QD or 250 mg/time,BID,425 mg/time, QD Until the disease progresses or patients can not tolerate the side effects. The follow-up time was 18 months, and the efficiency was evaluated and the side effects of the drug were observed.Results Forty patients had a disease control rate(DCR) of 60% and the median progression-free survival time(mPFS) is 4.5 months. In the univariate analysis, ECOG scores, combined therapy, and post-dose efficiency were analysised for median PFS,the differences were statistically significant,The other factors as gender, age, history of drinking or hepatitis,accompany cirrhosis decompensation and portal venous thrombosis, Child-Pugh classification, number of tumors, distant metastasis of tumors, AFP levels, Apatinib dose were analysised too,but there was no significant difference in the median PFS.Multivariate analysis found that post-dose efficiency was an independent influencing factor affecting PFS. The main adverse reactions were hemorrhage, hand-foot syndrome, gastrointestinal reactions, hypertension, etc. Most of them were grade I or II, and patients were able to tolerate or tolerate after reducing the amount of apatinib.Conclusion Apatinib is safe, effective and resistant for advanced primary liver cancer.
Objective To investigate the efficiency and safety of apatinib in the treatment of advanced primary liver cancer.Methods A retrospective analysis of 40 patients with advanced primary liver cancer was made, given apatinib 250 mg/time,QD or 250 mg/time,BID,425 mg/time, QD Until the disease progresses or patients can not tolerate the side effects. The follow-up time was 18 months, and the efficiency was evaluated and the side effects of the drug were observed.Results Forty patients had a disease control rate(DCR) of 60% and the median progression-free survival time(mPFS) is 4.5 months. In the univariate analysis, ECOG scores, combined therapy, and post-dose efficiency were analysised for median PFS,the differences were statistically significant,The other factors as gender, age, history of drinking or hepatitis,accompany cirrhosis decompensation and portal venous thrombosis, Child-Pugh classification, number of tumors, distant metastasis of tumors, AFP levels, Apatinib dose were analysised too,but there was no significant difference in the median PFS.Multivariate analysis found that post-dose efficiency was an independent influencing factor affecting PFS. The main adverse reactions were hemorrhage, hand-foot syndrome, gastrointestinal reactions, hypertension, etc. Most of them were grade I or II, and patients were able to tolerate or tolerate after reducing the amount of apatinib.Conclusion Apatinib is safe, effective and resistant for advanced primary liver cancer.
引文
[1] 原发性肝癌诊疗规范(2017年版)[J].临床医学研究与实践,2017,2(21):201.
[2] 高春.肝癌分子病理流行病学[J].世界华人消化杂志,2018,26(9):557-563.
[3] 陈孝平.肝恶性肿瘤[M].外科学.2版.北京:人民卫生出版社,2010:620.
[4] 鲁丁瑜,李娜,李志平.多靶点抗肿瘤新药阿帕替尼的研究进展[J].华西药学杂志,2017,32(1):104-108.
[5] Hicklin DJ,Ellis LM.Role of thevascular endothelial growth factorpathway in tumor growth and angiogenesis[J].J Clin Oncol,2005,23:1011-1027.
[6] 涂艳,彭枫.阿帕替尼治疗恶性肿瘤的临床研究进展[J].中国肿瘤临床,2016,43(12):545-548.
[7] Qin SK.Apatinib in Chinese patients with advanced hepatocellular carcinoma:A phaseⅡrandomized,open-label trial[J].J Clin Oncol,2014,32(15):17-20.
[2] 高春.肝癌分子病理流行病学[J].世界华人消化杂志,2018,26(9):557-563.
[3] 陈孝平.肝恶性肿瘤[M].外科学.2版.北京:人民卫生出版社,2010:620.
[4] 鲁丁瑜,李娜,李志平.多靶点抗肿瘤新药阿帕替尼的研究进展[J].华西药学杂志,2017,32(1):104-108.
[5] Hicklin DJ,Ellis LM.Role of thevascular endothelial growth factorpathway in tumor growth and angiogenesis[J].J Clin Oncol,2005,23:1011-1027.
[6] 涂艳,彭枫.阿帕替尼治疗恶性肿瘤的临床研究进展[J].中国肿瘤临床,2016,43(12):545-548.
[7] Qin SK.Apatinib in Chinese patients with advanced hepatocellular carcinoma:A phaseⅡrandomized,open-label trial[J].J Clin Oncol,2014,32(15):17-20.