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目的:观察阿帕替尼二线治疗晚期胃癌的客观疗效及毒副反应。方法:观察30例一线治疗失败的晚期胃癌患者,随机分为,随机分为观察组和对照组,观察组口服阿帕替尼:850 mg,每日1次,每4周为1个周期,对照组采用替吉奥80mg/m~2单药化疗,分2次餐后口服,连服14天,每21天为1个周期。4周期后评价两组患者的临床疗效和不良反应。结果:观察组15例患者中CR 0例,PR3例,SD 4例,PD 8例,ORR 20.0%,DCR46.7%;中位PFS 3.8个月,对照组15例患者中CR 0例,PR3例,SD 5例,PD 7例,ORR20.0%,DCR53.3%;中位PFS 3.5个月。,2组比较差异无统计学意义(P>0.05),生存获益方面,观察组和对照组患者均在ECOG评分、体重增加、饮食改善,睡眠改善,疼痛评分方面获得了不同程度的改善,阿帕替尼更具有优势。不良反应方面,观察组以出血、高血压、蛋白尿、手足皮肤反应为主,对照组以肝肾功能损伤,骨髓抑制,恶心呕吐、腹泻为主。大部分为I-II级。结论:阿帕替尼二线治疗晚期胃癌耐受性较好,疗效与替吉奥相当,能显著提高晚期胃癌患者的疾病控制率,带来生存获益。
Objective: To observe the objective curative effect and toxicity of second-line apatinib in the treatment of advanced gastric cancer. Methods: Thirty patients with advanced gastric cancer who failed in the first-line treatment were randomly divided into observation group and control group. The observation group received oral apatinib 850 mg once daily and one cycle every 4 weeks. The control group for the treatment of 80mg / m ~ 2 single-agent chemotherapy, divided into two meals after oral administration, and even served 14 days, every 21 days for a cycle. After 4 cycles, the clinical efficacy and adverse reactions in both groups were evaluated. Results: Among the 15 patients in the observation group, CR 0, PR 3, SD 4, PD 8, OR 20.0%, DCR 46.7%; median PFS 3.8 months, control group 15 patients CR 0, PR 3 Cases, SD 5 cases, PD 7 cases, ORR 20.0%, DCR 53.3%; median PFS 3.5 months. There was no significant difference between the two groups (P> 0.05). In terms of survival benefit, both the observation group and the control group improved to some extent in ECOG score, weight gain, diet improvement, sleep improvement and pain score, Apatinib is more advantageous. Adverse reactions, the observation group bleeding, hypertension, proteinuria, hand-foot skin reaction-based, the control group of liver and kidney function, bone marrow suppression, nausea and vomiting, diarrhea. Mostly I-II level. CONCLUSION: The second-line apatinib is better tolerated in advanced gastric cancer and its efficacy is comparable to that of substitute Gagio, which can significantly improve the disease control rate and benefit the survival of patients with advanced gastric cancer.