阿帕替尼治疗晚期胃癌的疗效预测和预后分析

doi:10.19401/j.cnki.1007-3639.2018.03.006

中国癌症杂志 ›› 2018, Vol. 28 ›› Issue (3): 203-209.doi: 10.19401/j.cnki.1007-3639.2018.03.006

阿帕替尼治疗晚期胃癌的疗效预测和预后分析

赵青芳¹，关露露¹，吕慧芳¹，陈贝贝¹，樊鑫鑫¹ ，王茂勋¹，高晓会²，郭彦伟³，陈小兵¹

1. 郑州大学附属肿瘤医院，河南省肿瘤医院肿瘤内科，河南郑州 450000 ；
2. 河南科技大学第一附属医院肿瘤内科，河南洛阳 471003 ；
3. 郑州大学第五附属医院肿瘤内科，河南郑州450052

出版日期:2018-03-30 发布日期:2018-04-11
通信作者: 陈小兵　E-mail: 2290773710@qq.com
基金资助:
国家自然科学基金（81472714）；河南省医学科技攻关计划重点项目（201502027）。

Analysis of the efficacy prediction and prognostic factors for advanced gastric cancer treated with apatinib

ZHAO Qingfang¹, GUAN Lulu¹, LÜ Huifang¹, CHEN Beibei¹, FAN Xinxin¹, WANG Maoxun¹, GAO Xiaohui², GUO Yanwei³, CHEN Xiaobing¹

1. Department of Oncology, Tumor Hospital Affiliated to Zhengzhou University, Tumor Hospital of Henan Province, Zhengzhou 450000, Henan Province, China; 2. Department of Oncology, the First Affiliated Hospital, Henan University of Science and Technology, Luoyang 471003, Henan Province, China; 3. Department of Oncology, the Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China

Published:2018-03-30 Online:2018-04-11
Contact: CHEN Xiaobing E-mail: 2290773710@qq.com

摘要/Abstract

摘要： 背景与目的：阿帕替尼是全球首个针对晚期胃癌的口服抗血管生成药物，随着其在临床上的广泛应用，寻找合适的疗效预测标志物及筛选敏感人群成为亟待解决的重要问题。该研究旨在观察阿帕替尼治疗晚期胃癌的疗效及安全性，寻找有效的临床预测预后因素。方法：回顾性分析2015年1月—2016年8月收治的105例晚期胃癌患者的临床资料，均给予单药口服阿帕替尼。观察指标为治疗相关不良反应、疾病控制率(disease control rate，DCR)及无进展生存期(progression-free survival，PFS)。分析临床病理特征及治疗相关不良反应与疗效及预后的关系。结果：全组患者总体中位PFS(median DFS，mPFS)为71 d(95%CI：50.1~91.9 d)，客观缓解率(objective response rate，ORR)为5.71%，DCR为65.71%。单因素分析显示，年龄大于56岁、ECOG评分0~1分、药物剂量500 mg、高血压、手足皮肤反应(hand-foot skin reaction，HFSR)、蛋白尿者PFS显著延长；而ECOG评分0~1分、药物剂量500 mg、高血压、HFSR、蛋白尿、腹泻者DCR较高。Cox和Logistic多因素分析显示，ECOG评分(P=0.007)、药物剂量(P=0.014)、高血压(P=0.012)及治疗相关HFSR(P=0.046)是阿帕替尼治疗晚期胃癌PFS的独立预后因素。ECOG评分0~1分(P=0.014)、高血压(P=0.043)及HFSR(P=0.012)与DCR高显著相关。结论：阿帕替尼治疗晚期胃癌患者具有良好的有效性和可控的安全性。ECOG评分、治疗期间出现高血压及HFSR是阿帕替尼治疗晚期胃癌DCR和PFS的独立预测因素，而药物剂量可作为PFS的独立预测因素。

关键词: 胃癌, 阿帕替尼, 多因素分析, 预后指标

Abstract: Background and purpose: Apatinib is the first oral cancer antiangiogenic drug in the world for advanced gastric cancer. With its wide application in clinics, finding suitable predictors of efficacy and screening for sensitive populations have become important issues. This study aimed to observe the efficacy and safety of apatinib in the treatment of advanced gastric cancer, and explore clinical prediction and prognostic factors. Methods: The clinicopathological features of 105 patients with advanced gastric cancer, who were treated with apatinib from Jan. 2015 to Aug. 2016, were analyzed retrospectively. All patients were given oral administration of apatinib. The indicators were treatment-related adverse reactions, disease control rate (DCR) and progression-free survival (PFS). We analyzed the relationship between clinicopathological features, treatment-related adverse reactions and prognosis. Results: The median PFS (mPFS) was 71 d (95%CI: 50.1-91.9 d), the objective response rate was 5.71%, and DCR was 65.71%. The univariate analysis showed that PFS was significantly prolonged among patients with one of the potential prognostic factors including age of >56 years, ECOG PS 0-1, dose 500 mg, hypertension, hand-foot skin reaction (HFSR) and proteinuria. The DCR was higher among patients with one of the potential prognostic factors including ECOG PS 0-1, dose 500 mg, hypertension, HFSR, proteinuria and diarrhea. Cox and logistic multivariate analysis showed that ECOG PS, dose, hypertension, HFSR were independent prognostic factors of PFS. ECOG PS 0-1, treatment-related HFSR, hypertension were significantly associated with DCR. Conclusion: Apatinib has good efficacy and safety in the patients with advanced gastric cancer. ECOG PS, HFSR, hypertension are the favorable prognostic factors of PFS and DCR, and the drug dose can be used as an independent predictor of PFS.

Key words: Gastric cancer, Apatinib, Multivariate analysis, Prognostic indicators

赵青芳,关露露,吕慧芳,等. 阿帕替尼治疗晚期胃癌的疗效预测和预后分析[J]. 中国癌症杂志, 2018, 28(3): 203-209.

ZHAO Qingfang, GUAN Lulu, Lü Huifang, et al. Analysis of the efficacy prediction and prognostic factors for advanced gastric cancer treated with apatinib[J]. China Oncology, 2018, 28(3): 203-209.

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阿帕替尼治疗晚期胃癌的疗效预测和预后分析

Analysis of the efficacy prediction and prognostic factors for advanced gastric cancer treated with apatinib

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