摘要
目的:探讨依维莫司联合索拉菲尼治疗复发难治性骨肉瘤的近远期临床疗效及对患者血清肿瘤特异性生长因子(TSGF)、血管内皮生长因子(VEGF)、Ras和ErbB3水平的影响。方法:选取我院2016年1月至2017年12月收治的二线放化疗(吉西他滨联合多西他赛)失败的复发难治性骨肉瘤患者60例,按照随机数字表法均分为观察组和对照组,每组30例。对照组患者给予索拉菲尼治疗,观察组患者在此基础上加用依维莫司进行治疗。观察两组患者的近远期临床疗效、中位无进展生存期(PFS)和中位总生存期(OS),对血清TSGF、VEGF、Ras和ErbB3水平变化及不良反应发生情况进行比较。结果:观察组和对照组的疾病控制率分别为76.67%和50.00%,观察组明显高于对照组,两组之间有显著性差异(P<0.05)。治疗前两组患者TSGF、VEGF、Ras和ErbB3水平比较,差异无统计学意义(P>0.05);与治疗前相比,治疗后两组患者的TSGF、VEGF、Ras和ErbB3水平均显著降低,且观察组明显低于对照组,差异有统计学意义(P<0.05)。观察组患者中位无进展生存期(PFS)为39天,中位总生存期(OS)为86天;对照组中位PFS为28天,中位OS为75天,观察组中位PFS和OS时间均优于对照组。观察组患者发生口腔炎的比例(73.33%)远大于对照组(6.66%),两组患者手足皮肤综合征发生率均大于50.00%。其他不良反应如皮疹、高血糖、血小板减少等两组均有出现,但症状较轻,两组比较差异不明显。结论:依维莫司联合索拉菲尼治疗复发难治性骨肉瘤近远期临床疗效显著,能较好的控制病情进展,并且明显降低骨肉瘤患者血清TSGF、VEGF、Ras和ErbB3水平,不良反应较轻,耐受良好,总体疗效优于索拉菲尼单药治疗。
Objective:To investigate the near and forward clinical efficacy of everolimus combined with sorafenib on relapsed and refractory osteosarcoma and the effect on serum tumor specific growth factor(TSGF),vascular endothelial growth factor(VEGF),Ras and ErbB3 levels in patients.Methods:60 patients with relapsed and refractory osteosarcoma treated in our hospital from January 2016 to December 2017 were selected and divided into the observation group and the control group,according to the random number table method,with 30 cases in each group.The patients in the control group were treated with sorafenib,and the patients in the observation group were treated with everolimus on the basis of the treatment.The clinical efficacy of the two groups in the near and long term,the changes of serum TSGF,VEGF,Ras and ErbB3 levels,and the incidence of adverse reactions were observed and compared between the two groups.Results:The rate of disease control in the observation group and the control group were 76.67% and 50.00% respectively,and the observation group was significantly higher than the control group.There was a significant difference between the two groups( P <0.05).There was no significant difference in the levels of TSGF,VEGF,Ras and ErbB3 in the two groups before treatment( P >0.05).Compared with before treatment,the levels of TSGF,VEGF,Ras and ErbB3 were significantly lower in the two groups after treatment,and the observation group was significantly lower than the control group,and the difference was statistically significant( P <0.05).In the observation group,the median progression free survival(PFS) was 39 days and the median total survival time(OS) was 86 days.The median PFS in the control group was 28 days and the median OS was 75 days.The median PFS and OS in the observation group were better than that in the control group.The proportion of patients with stomatitis in the observation group(73.33%) was higher than that in the control group(6.66%).The incidence of hand and foot skin syndrome in the two groups were higher than 50.00%.Other adverse reactions,such as rash,hyperglycemia and thrombocytopenia were found in the two groups,but the symptoms were lighter,and the two groups were not significantly different.Conclusion:The effect of everolimus combined with sorafenib on relapsed and refractory osteosarcoma is significant.It can better control the progress of the disease,and obviously reduce the serum TSGF,VEGF,Ras and ErbB3 levels in the patients with osteosarcoma.The adverse reaction is mild and well tolerated,and the overall efficacy is better than single sorafenib treatment.
作者
孙艳芳
朱卫红
Sun Yanfang;Zhu Weihong(Department of Clinical Laboratory,Union Chest Hospital,Henan Zhoukou 466000,China;Department of Blood Transfusion,Union Chest Hospital,Henan Zhoukou 466000,China)
出处
《现代肿瘤医学》
CAS
2019年第13期2379-2383,共5页
Journal of Modern Oncology
基金
河南省科技攻关项目(编号:153102310543)
