阿帕替尼联合替吉奥与奥沙利铂治疗老年晚期胃癌的疗效及预后比较

Comparison of efficacy and prognosis of apatinib combined with S-1 and oxaliplatin in treatment of advanced gastric cancer in elderly patients

中文关键词: 老年  晚期胃癌  阿帕替尼  SOX方案  临床疗效  生存期  预后

英文关键词: elderly  advanced gastric cancer  apatinib  SOX regimen  clinical efficacy  survival period  prognosis

中文摘要:

      目的 分析并比较阿帕替尼联合替吉奥与奥沙利铂(SOX)化疗方案治疗老年晚期胃癌的临床疗效及预后.方法 回顾性选取2020年5月—2022年10月邯郸市第一医院收治的86例老年晚期胃癌患者的临床资料,根据不同化疗方案将患者分为SOX组(n=42)和阿帕替尼联合组(n=44).SOX组采用常规替吉奥与奥沙利铂化疗方案,阿帕替尼联合组在SOX组治疗的基础上联合使用阿帕替尼;以21 d为1个治疗周期,2组均治疗2个周期.对比2组临床疗效、预后、生存期及不良反应.结果 SOX组和阿帕替尼联合组的ORR分别为23.81％和29.55％,差异无统计学意义(x2=0.361,P=0.548);DCR分别为54.76％和77.27％,差异有统计学意义(x2=4.872,P=0.027).2组治疗后6个月、治疗后1年内的总生存率差异均无统计学意义(x2=1.106、2.968,P=0.293、0.085),而阿帕替尼联合组治疗后2年内的总生存率高于SOX组(x2=4.128,P=0.042),2组OS差异无统计学意义(t=1.526,P=0.131),阿帕替尼联合组PFS长于SOX组(t=2.955,P=0.004).2组Ⅰ～Ⅳ度及Ⅲ～Ⅳ度不良反应发生率差异均无统计学意义(P＞0.05).结论 阿帕替尼联合SOX化疗方案疾病控制率优于SOX方案,且患者2年内生存率更高,PFS更长,临床应用相对安全.

英文摘要:

      Objective To analyze and compare the clinical efficacy and prognosis of apatinib combined with S-1 and oxaliplatin(SOX)chemotherapy regimens in the treatment of elderly patients with advanced gastric cancer.Methods The clinical data of 86 patients with advanced gastric cancer treated in First Hospital of Handan City were retrospectively analyzed.According to the different clinical chemotherapy regimens,they were divided into SOX group(n=42)and apatinib combina-tion group(n=44).The SOX group received conventional chemotherapy regimens of S-1 and SOX,while the apatinib combi-nation group received apatinib in addition to the treatment in the SOX group.21 days were one treatment cycle,and both groups were treated for two cycles.The clinical efficacy,prognosis,survival period and adverse reactions were compared be-tween the two groups.Results The objective response rate(ORR)was 23.81％in the SOX group and 29.55％in the apa-tinib combination group,with no statistically significant difference(x2=0.361,P=0.548).The disease control rate(DCR)in the apatinib combination group(77.27％)was significantly higher than that in the SOX group(54.76％)(x2=4.872,P=0.027).There was no statistically significant difference in the overall survival rate between the two groups at 6 months and within 1 years after treatment(x2=1.106,2.968;P=0.293,0.085).However,the overall survival rate within 2 years after treatment in the apatinib combination group was higher than that in the SOX group(x2=4.128,P=0.042).No significant difference was found in overall survival(OS)between the two groups(t=1.526,P=0.131).The progression-free survival(PFS)in the apatinib combination group was significantly longer than that in the SOX group(t=2.955,P=0.004).There was no statistically significant difference in the incidence of grade Ⅰ-Ⅳ and grade Ⅲ-Ⅳ adverse reactions between the two groups(P＞0.05).Conclusion The DCR of the apatinib combined with SOX chemotherapy regimen is superior to that of the SOX regimen.It has higher survival rate within 2 years and longer PFS.Its clinical application is relatively safe.