【摘要】 目的评估阿帕替尼联合化疗作为二线及以上治疗方案在晚期胃癌(GC)或胃食管结合部腺癌(AGEJ)患者中的疗效。方法分析行肿瘤介入治疗的129例晚期GC或AGEJ患者的临床资料,包括性别、年龄、ECOG分级、化疗方案、病理分级、原发病灶部位、既往是否行胃切除术、转移情况、转移灶个数、既往化疗及是否接受放疗,并记录无进展生存期(PFS)。按照治疗方法不同分为单独化疗组(77例,接受单独化疗)和联合化疗组(52例,接受阿帕替尼联合化疗),分析比较两组的临床资料。结果联合化疗组患者疾病控制率(DCR)高于单独化疗组(P<0.05)。联合化疗组PFS显著长于单独化疗组患者(P<0.05),转移灶个数≤2个患者的PFS显著长于转移灶个数>2个的患者(P<0.05)。多因素Cox回归分析结果显示,转移灶个数>2个和阿帕替尼联合化疗方案是PFS的独立影响因素。结论与单独化疗比较,阿帕替尼联合化疗方案作为二线及以上方案,可以显著提高既往至少一线化疗失败的晚期GC或AGEJ患者疾病控制率,延长患者的无进展生存期,且不良反应可控。更多还原

【Abstract】 Aim To compare the therapeutic effects between apatinibplus chemotherapy and chemotherapy alone as second-line or later-line therapy in advanced gastric cancer(GC) or adenocarcinoma of the gastroesophageal junction(AGEJ) patients. Methods Clinical data of advanced GC or AGEJ patients, including age, gender, Eastern Cooperative Oncology Group(ECOG) performance status, chemotherapy regimen, pathological grading, location of primary lesion, previous gastrectomy, metastases, previous chemotherapy or radiotherapy were retrospectively collected, and the progression-free survival(PFS) was recorded. Results A total of 129 patients with advanced GC or AGEJ met the inclusion and exclusion criteria, of which 52 patients received apatinibplus chemotherapy and 77 patients received chemotherapy alone. Baseline data of the two groups were comparable. The disease control rate(DCR) of patients in the apatinibplus chemotherapy group was higher than that of chemotherapy alone group(P<0.05). The median PFS of apatinbplus chemotherapy group was obviously longer than that of chemotherapy alone group(P<0.05). The median PFS of patients with metastatic lesions ≤2 was significantly longer than that of patients with metastatic lesions >2(P<0.05). Cox regression analysis revealed that patients with metastatic lesions >2 and apatinib plus chemotherapy regimen were independently associated with PFS. Conclusion Compared with chemotherapy alone, apatinib plus chemotherapy as second-line or later-line therapy could significantly improve DCR and prolong the PFS in advanced GC or AGEJ patients who had failed in at least first-line chemotherapy with manageable toxicity.更多还原