摘要
目的:观察阿帕替尼联合全身化疗用于胃肠胰神经内分泌肿瘤(GEP-NEN)肝转移的疗效和安全性。方法:选择2016年1月-2018年1月于湖北省肿瘤医院就诊的GEP-NEN肝转移患者60例,按随机数字表法分为全身化疗组、阿帕替尼组和联合组,每组各20例。全身化疗组患者给予依托泊苷注射液80 mg/m^2,每日1次,d1-5,静脉滴注+注射用顺铂20 mg/m^2,每日1次,d1-5,静脉滴注,每3周为1个周期;阿帕替尼组患者给予甲磺酸阿帕替尼片0.5 g,每日1次;联合组患者用药方法同全身化疗组+阿帕替尼组。3组患者均连续治疗3个月。观察3组患者的临床疗效,治疗前后的血清肿瘤标志物[血清癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)、嗜铬粒蛋白A(CgA)和癌抗原19-9(CA19-9)]水平,治疗后生存情况及治疗期间的不良反应发生情况。结果:联合组患者客观缓解率、疾病控制率、中位总生存期、生存率均显著高于或长于全身化疗组和阿帕替尼组,中位无进展生存期、不良反应发生率均显著短于或低于全身化疗组和阿帕替尼组(P<0.05)。治疗后,3组患者CEA、NSE、CgA、CA19-9水平均显著低于同组治疗前,且联合组显著低于全身化疗组及阿帕替尼组(P<0.05)。全身化疗组患者上述指标与阿帕替尼组比较,差异均无统计学意义(P>0.05)。结论:阿帕替尼联合全身化疗用于GEP-NEN肝转移的疗效与安全性均较好,可降低患者的血清肿瘤标志物水平,延长患者生存期,提高其生存率。
OBJECTIVE:To observe the efficacy and safety of apatinib combined with systemic chemotherapy for hepatic metastasis of gastroenteropancreatic neuroendocrine neoplasms(GEP-NEN).METHODS:Totally 60 patients with GEP-NEN in Hubei Provincial Tumor Hospital from Jan.2016 to Jan.2018 were randomly divided into systemic chemotherapy group,apatinib group and combination group,with 20 patients in each group.Systemic chemotherapy group was given Etoposide injection 80 mg/m^2,once a day d1-5,intravenously+Cisplatin for injection 20 mg/m^2,once a day d1-5,intravenously,every 3 weeks for a cycle.Apatinib group was given Apatinib mesylate tablets 0.5 g,once a day.Combination group received treatment as systemic chemotherapy group+apatinib group.All three groups were treated continuously for 3 months.The clinical efficacies of 3 groups were observed.The serum levels of tumor markers(CEA,NSE,CgA and CA19-9)before and after treatment,survival situation after treatment and the occurrence of ADR during treatment were also observed.RESULTS:The objective remission rate,disease control rate,median overall survival and survival rate of combination group were significantly higher or longer than those of systemic chemotherapy group and apatinib group.Median progression-free survival and the incidence of ADR were significantly shorter or lower than systemic chemotherapy group and apatinib group(P<0.05).After treatment,the levels of CEA,NSE,CgA and CA19-9 in 3 groups were significantly lower than before treatment,and combination group was significantly lower than systemic chemotherapy group and apatinib group(P<0.05).There was no statistical significance in above indexes between systemic chemotherapy group and apatinib group(P>0.05).CONCLUSIONS:Apatinib combined with systemic chemotherapy for liver metastasis of GEP-NEN is effective and safe,which can improve the level of serum tumor markers,prolong the survival time of patients and improve survival rate.
作者
熊锐
尹涛
段传谊
高建龙
江建新
XIONG Rui;YIN Tao;DUAN Chuanyi;GAO Jianlong;JIANG Jianxin(Second Ward,Dept.ofHepatobiliary and Pancreatic Surgery,Hubei Provincial Tumor Hospital,Wuhan 430079,China;Dept.of Hepatobiliary Surgery,Hubei Provincial People’s Hospital,Wuhan 430060,China)
出处
《中国药房》
CAS
北大核心
2019年第6期821-824,共4页
China Pharmacy
基金
国家自然科学基金资助项目(No.81572429)
关键词
阿帕替尼
全身化疗
依托泊苷
顺铂
胃肠胰神经内分泌肿瘤
肝转移
疗效
安全性
Apatinib
Systemic chemotherapy
Etoposide
Cisplatin
Gastroenteropancreatic neuroendocrine neoplasm
Liver metastasis
Efficacy
Safety
