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甲磺酸阿帕替尼片单药三线治疗VEGFR-2高表达晚期非鳞NSCLC患者的近期疗效和安全性体会
作者:王婷  马惠文  王东林  李代蓉  邵江河  王思雄 
单位:重庆大学附属肿瘤医院/重庆市肿瘤研究所/重庆市肿瘤医院肿瘤内科  重庆 400030 
关键词: 非小细胞肺/药物疗法 肺肿瘤/药物疗法 血管内皮生长因子受体2/药物作用 基因表达 血管生成抑制剂/投药和剂量 治疗结果 安全 
DOI:R734.2;R730.53
出版年,卷(期):页码:2018,33(5):410-415
摘要:

目的 探讨阿帕替尼单药三线治疗血管内皮生长因子受体-2(vascular endothelial growth factor receptor-2,VEGFR-2)高表达的晚期非鳞非小细胞肺癌(non-small-cell lung cancer,NSCLC)患者的近期疗效及安全性。方法 采用随机数字表法将40例VEGFR-2高表达的晚期非鳞NSCLC患者分为观察组和对照组,每组20例,分别采用阿帕替尼和多西他赛治疗,21 d为1个周期,进行4个周期治疗。阿帕替尼500 mg/d持续口服;多西他赛75 mg/m2,第1天使用。2、4个周期后比较两组疗效,观察阿帕替尼治疗出现的不良反应。结果 治疗2个周期后观察组和对照组有效率分别为15.0%和10.0%,疾病控制率分别为85.0%和75.0%,两组比较,差异均无统计学意义(均P>0.05)。治疗4个周期的观察组16例,对照组13例。观察组和对照组有效率分别为6.2%和0%,疾病控制率分别为87.5%和46.2%,两组比较,差异均具有统计学意义(均P<0.05)。观察组患者KPS评分高于对照组(P<0.05)。阿帕替尼存在的药物不良反应主要为高血压(35.0%)、手足综合征(35.0%)、乏力(30.0%)和腹泻(25.0%),多数为NCI 1~2级(69.2%)。结论 阿帕替尼可作为VEGFR-2高表达的晚期非鳞NSCLC患者的三线选择用药,近期疗效可,不良反应可耐受。

Objective To investigate the short-term efficacy and safety of apatinib mesylate tablets in the third-line treatment of advanced non-squamous non-small-cell lung cancer (NSCLC) with high vascular endothelial growth factor receptor 2 (VEGFR-2) expression. Methods Forty cases of non-squamous NSCLC patients were enrolled,and assigned into the test group or the control group by random number table,with 20 patients each. The test group and the control group were treated with apatinib and docetaxel,respectively. The time course was 4-cycle with every 21 d as one cycle for both groups. The dosage was 500 mg/d apatinib orally everyday for the test group,and 75 mg/m2 docetaxel only on the first day of each cycle for the control group. The effects were com365bet娱乐官网网址pared between the two groups after 2 and 4 cycles of treatment,and the adverse reactions in the apatinib-treated group were analyzed. Results After two cycles,the response rates were 15.0% and 10.0% in the test group and the control group respectively,and the disease control rates were 85.0% and 81.0% respectively,with no statistical difference between the two groups (P>0.05). Sixteen patients in the test group and 13 patients in the control group have completed 4 cycles of treatment. The response rates were 6.2% and 0% respectively,and the disease control rates were 87.5% and 46.2% respectively,in the test group and the control group. The differences for both indices were significant between the two groups (both P<0.05). Moreover,the KPS score of the test group was higher than that of the control group (P<0.05). Most adverse reactions of apatinib were NCI 1-2 (69.2%),which included hypertension (35.0%),hand foot syndromes (35.0%),fatigue (30.0%) and diarrhea (25.0%). Conclusion Apatinib shows good efficacy and tolerable toxicity in the treatment of advanced non-squamous NSCLC with high VEGFR-2 expression,and is a good candidate for the third-line chemotherapy.

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