摘要
目的探讨替吉奥联合阿帕替尼一线治疗晚期胃癌的临床疗效及不良反应。方法选取河南省肿瘤医院、安阳肿瘤医院、河南科技大学第一附属医院三家医院2015年1月至2016年1月收治的30例晚期胃癌患者为研究对象,将入选患者按照随机数表法分为试验组和对照组,每组各15例。试验组患者采用化疗联合靶向治疗:阿帕替尼500 mg,口服,每天1次;替吉奥胶囊40~60 mg,每天2次,口服,第1~14天;21天为一周期,至少完成4个周期的治疗。对照组患者采用单纯化疗:替吉奥胶囊40~60 mg,每天2次,口服,第1~14天,21天为一周期,至少完成4个周期的治疗。每2个周期评价1次疗效,两组患者的辅助治疗方法一致。以实体肿瘤疗效评价标准1.1版(response evaluation criteria in solid tumors version 1.1,RECIST 1.1)进行疗效评价,以WHO抗癌药物常见不良反应分级标准评价不良反应,以卡氏行为状态(Karnofsky performance status,KPS)评分标准评价生活质量,以营养风险筛查2002(nutritional risk screening 2002,NRS 2002)评估营养状态。结果试验组患者疗效明显优于对照组(P<0.05)。试验组患者血红蛋白水平下降、消化道反应和高血压发生率均明显高于对照组(P<0.05),其他不良反应发生率两组间无明显差异(P>0.05)。治疗后试验组患者生活质量明显低于对照组(P<0.05)。治疗后试验组患者营养状态评分明显高于治疗前(P<0.05),且明显高于治疗后对照组(P<0.05)。结论替吉奥联合阿帕替尼一线治疗晚期胃癌的近期疗效肯定,但不良反应多,且患者生活质量、营养状况下降明显,该联合治疗方案是否值得临床应用有待进一步探讨。
Objective To evaluate the effect and toxicity of Apatinib combined with S-1 for advanced gastric cancer. Method 30 patients with advanced gastric cancer in Henan Cancer Hospital, An Yang Tumor Hospital, and the First Affiliated Hospital of Henan University of Science and Technology from January 2015 to January 2016 were randomly （using random number table method） divided into experimental group and control group, patients in the two groups were all treated at least 4 cycles. Experimental group included 15 patients were treated with S-140 ~ 60 mg, bid, from d1 to d14; Apatinib 500 mg, qd, and repeated every 3 weeks. Control group patients were treated with S-140 ~ 60 mg , bid, from d1 to d14, and repeated every 3 weeks. The effect and toxicity in the two groups were evaluated every 2 cycles of treatment, and the treatment for adverse reactions were the same in the two groups. Used the response evaluation criteria in solid tumors version 1.1 （RECIST 1.1） to estimate the objective curative effect, the common anticancer drug toxicity grading standard （WHO） to evaluate the adverse reactions, Karnofsky performance status （KPS） to evaluate the quality of life, the nutritional risk screening 2002 （NRS 2002） to evaluate the status of nutrition. Result The effect of experimental group was significantly better than that of control group （P 〈 0.05）. Except hemoglobin decreased, digestive tract reaction and hypertension, incidence rate of other adverse reactions had no significantly differences in two groups （P 〈 0.05）. After treatment, the quality of life in experimental group was significantly worse than that in control group （P 〈 0.05）. After treatment, the NRS 2002 score in experimental group was significantly higher than before treatment （P 〈 0.05）, and after treatment the score in experimental group was significantly higher than that in control group （P 〈 0.05）. Conclusion The combination by S-1 and Apatinib is effective in the treatment of patients with advanced gastric cancer, but too many adverse reactions come out and the quality of life and nutritional status decline obviously, which deserves further clinical research to probe the clinical utility.
出处
《中国医学前沿杂志（电子版）》
2017年第2期63-67,共5页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
基金
国家自然科学基金面上项目(81472714)
关键词
替吉奥
阿帕替尼
晚期胃癌
化疗
S-1
Apatinib
Advanced gastric cancer
Chemotherapy
