【摘要】 目的 分析安罗替尼三线及以上治疗晚期非小细胞肺癌(NSCLC)有效性和安全性。方法 回顾性分析2019年5月～2021年8月在宁国市人民医院肿瘤内科接受安罗替尼三线及以上治疗2周期以上的60例晚期NSCLC患者临床资料。观察患者的无进展生存期(PFS)、总生存期(OS)、客观缓解率(ORR)、疾病控制率(DCR)以及不良反应，利用kaplan-Meier生存分析，log-rank进行差异性检验，采用Cox回归多因素分析影响预后因素。结果 60例患者中位PFS为4.90月(95%CI=3.637～6.163),中位OS为8.90月(95%CI=7.726～10.074),ORR和DCR分别为8.3%(5/60)和55.0%(33/60)。PFS单因素分析结果示，年龄、ECOG评分和EGFR突变状态、脑转移情况可能与PFS相关(P<0.05)。Cox多因素回归分析PFS结果示，基因突变情况和脑转移情况是影响患者PFS的独立预后因素(P<0.05)。OS单因素分析结果示，脑转移情况与OS相关(P<0.05)。安罗替尼常见的不良反应Ⅰ～Ⅱ级为主，包括食欲下降、疲乏、高血压、促甲状腺激素升高、咯血、手足综合征等。结论 安罗替尼作为晚期NSCLC患者三线以上治疗效果确切，不良反应可控，其中EGFR突变阳性和无脑转移患者PFS获益大，无脑转移患者OS获益大。更多还原

【Abstract】 Objective To analyze the safety and efficacy of anlotinib as third-line treatment and above in the advanced non-small cell lung cancer(NSCLC).Methods The clinical data of 60 patients with advanced NSCLC who received more than 2 cycles of third-line treatment and above with anlotinib from May 2019 to August 2021 in our hospital were retrospectively analyzed. Progression-free survival(PFS), overall survival(OS),objective response rate(ORR), disease control rate(DCR) and adverse reactions were observed. Kaplan-meier survival analysis and Log-rank difference test were used. Univariate differences were analyzed by Cox regression.Results The median PFS was 4.90 months(95%CI=3.637 ～ 6.163), the median OS was 8.90 months(95%CI=7.726 ～ 10.074), ORR and DCR were 8.3%(5/60) and 55.0%(33/60), respectively. Univariate analysis of PFS showed that age, ECOG score EGFR, gene mutation status and brain metastasis were correlated with PFS(P < 0.05). Cox multivariate regression analysis of PFS showed that gene mutation status and brain metastasis were independent prognostic factors of PFS(P < 0.05). OS univariate analysis showed that brain metastasis was correlated with OS(P < 0.05). The common grade Ⅰ ～ Ⅱ symptoms of anlotinib are decreased appetite, fatigue, hypertension, elevated thyroid stimulating hormone, hemoptysis, hand-foot syndrome.Conclusion Anlotinib has a definite therapeutic effect and controllable adverse reactions in patients with advanced NSCLC above the third line. Patients with EGFR mutation positive and no BMS have a greater benefit in PFS, and patients without BMS have a greater benefit in OS.更多还原