摘要
目的:探讨在不可切除晚期胃癌转化治疗中服用阿帕替尼的安全性及有效性。方法:回顾性分析2017年3月至2018年6月天津医科大学肿瘤医院收治的33例晚期胃癌服用阿帕替尼转化治疗病例。合并腹膜转移或卵巢转移组,予以阿帕替尼+紫杉醇+S1方案(紫杉醇:50 mg/m^2iv,20 mg/m^2ip,d1,d8,q3w;S1:60 mg,bid,d1~d14;阿帕替尼:500 mg,qd),非腹膜转移或卵巢转移组,予以阿帕替尼+SOX方案化疗(奥沙利铂130 mg/m^2;S1:60 mg,bid,d1~d14;阿帕替尼:500 mg,qd),经多学科联合会诊(multiple disciplinary team,MDT)后评估为可根治手术的患者停用1个周期阿帕替尼后行手术治疗。结果:经转化治疗后,33例患者中部分缓解(partial response,PR)21例,疾病进展(progressive disease,PD)8例,客观缓解率(objective response rate,ORR)为75.7%。22例患者转化后行手术治疗,R0手术切除率63.6%,术中清扫淋巴结(57.0±15.6)枚,手术时间(212.0±44.8)min,术中出血(164±46)mL,术后住院时间(13.0±2.7)d。手术组中位无进展生存期(median progression free survival,mPFS)为10.5个月,中位总生存期(median overall survival,mOS)为16.5个月,未手术组mPFS为2.5个月,mOS为5.5个月。结论:晚期胃癌转化治疗中联合抗血管生成药物阿帕替尼可以获得较高的R0切除率,且安全可靠。
Objective:To investigate the safety and efficacy of fluorouracil-based two-drug combination chemotherapy with apatinib,as a conversion therapy,in patients with unresectable gastric cancer(GC).Methods:A retrospective analysis of 33 patients with unresectable stage IV GC receiving conversion therapy at Tianjin Medical University Cancer Institute and Hospital between March 2017 and June 2018,was performed.Patients with peritoneal or ovarian metastasis received S1/paclitaxel(PTX)/apatinib(S1:60 mg,bid,days 1-14;PTX:50 mg/m^2iv,days 1 and 8;PTX:20 mg/m^2ip,days 1 and 8;q3 w;apatinib 500 mg po,qd).Patients with other non-curable factors were administered a regimen of SOX plus apatinib(oxaliplatin 130 mg/m^2,S1:60 mg,bid,days 1-14;apatinib 500 mg po,qd).Apatinib should be withdrawn from the last cycle before surgery.Surgery should be performed after MDT.Results:After at least three cycles chemotherapy,21 patients achieved partial response(PR)and 8 patients had progressive disease(PD),resulting in an objective response rate of 75.7%.Surgery was performed on 22 patients with PR,and 21 patients(63.6%)achieved R0 resection;the number of excised lymph nodes was 57.0±15.6,intraoperative hemorrhage was(164±46)mL,the operation time was(212.0±44.8)min,and the postoperative hospital stay was(13.0±2.7)days.Patients who had surgery had a median progression free survival(mPFS)of 10.5 months and an median overall survival(mOS)of 16.5 months;for patients who did not undergo surgery,the median progression free survival(mPFS)was 2.5 months and mOS was 5.5 months.Conclusions:As a conversion therapy,fluorouracil-based two drug-combination chemotherapy with apatinib provided a high R0 resection rate for unresectable stageⅣGC,with an acceptable safety profile.
作者
蔡明志
王学军
邓靖宇
梁寒
Mingzhi Cai;Xuejun Wang;Jingyu Deng;Han Liang(Center for Cancer,Tianjin Key Laboratory of Cancer Prevention and Therapy,TianJin's Clinical Research Center for Cancer,Tianjin 300060,China)
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2020年第9期446-449,共4页
Chinese Journal of Clinical Oncology
基金
天津医科大学临床医学研究项目(编号:2017kylc002)资助。
关键词
阿帕替尼
胃癌
转化治疗
安全性
疗效
apatinib
gastric cancer(GC)
conversion therapy
safety
efficacy
